Organization Active NPI

Avon Convalescent Home, Inc.

Doing business as Avon Health Center

  • Skilled Nursing Facility
  • Avon, CT
National Provider Identifier
1629004395
Registry record updated Nov 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
938-C Issued in CT
Legal business name
AVON CONVALESCENT HOME, INC.
Doing business as
Avon Health Center
Practice address
652 W Avon Rd
Avon, CT 06001-2906
Phone
(860) 673-2521
Fax
(860) 675-1587
NPI assigned
Jun 24, 2006
Last updated
Nov 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Russell Schwartz
Title
V.P. / Director of Operation
Phone
(860) 490-9855

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 938-C CT Primary

Addresses

Primary practice location

652 W Avon Rd
Avon, CT 06001-2906

Mailing address

652 W Avon Rd
Avon, CT 06001-2906
Phone (860) 673-2521

Other identifiers 1

IdentifierTypeStateIssuer
000009381MedicaidCT

Other names 1

  • Avon Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120208000354 CT Part A Provider - Skilled Nursing Facility 0648334300 Practice locations: Avon, CT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629004395. Details of each certification follow.

Skilled nursing facility certification: CCN 075244

Legal name
AVON CONVALESCENT HOME, INC.
Doing business as
AVON HEALTH CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 1, 1976
Last certification
Jul 22, 2024
Beds
120
Ownership / control type
Corporation
Organization structure
CorporationProprietary
Incorporated
Apr 16, 1975 in CT
Enrollment address
652 W Avon Rd
Avon, CT 06001-2906
Nursing home name
AVON HEALTH CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Avon Health CenterCCN 075244 · All quality measures
Overall star rating
2 of 5
Health inspections
1 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Nov 1, 1976
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12099.8 residents per day on average
Penalties (3 years)
2Fines totaling $45,838

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D0673774Avon Convalescent Home, Inc652 West Avon Rd, Avon, CT 06001Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

652 W Avon Rd
Avon, CT 06001
Phone (860) 673-2521

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Avon Convalescent Home, Inc. Organization, Avon, CT Corporation, For-profit 5% Or Greater Direct Ownership Interest Dec 21, 1974 100%
Freda Schwartz Individual Corporate OfficerPresident and Secretary Jun 29, 1983 100%
Corporate DirectorDirector Jun 29, 1983 100%
Amy Pellerin Individual W-2 Managing EmployeeAdministrator Dec 19, 2022 100%
Operational/Managerial ControlAdministrator Dec 19, 2022 100%
Russell C Schwartz Individual Corporate OfficerVice President Oct 25, 2007 100%
Corporate DirectorDirector Jun 23, 2015 100%

Practitioners & affiliated clinicians

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447977600000",
    "number": "1629004395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 W AVON RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060012906",
            "telephone_number": "860-673-2521",
            "fax_number": "860-675-1587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "652 W AVON RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060012906",
            "telephone_number": "860-673-2521",
            "fax_number": "860-675-1587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVON CONVALESCENT HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2015-11-20",
        "status": "A",
        "authorized_official_last_name": "SCHWARTZ",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "V.P. / DIRECTOR OF OPERATION",
        "authorized_official_telephone_number": "860-490-9855",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "938-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000009381",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avon Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Avon, CT

Sources for this page

Verify at the official NPI Registry.