Active NPI
Avon Convalescent Home, Inc.
Doing business as Avon Health Center
- Skilled Nursing Facility
- Avon, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 938-C
- 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, 2015
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000009381 | Medicaid | CT |
Other names 1
- Avon Health Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Corporation
- 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 Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Nov 1, 1976
- Medicare certification status
- Active
- Certified beds
- 120
- Penalties (3 years)
- 2
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 07D0673774 | Avon Convalescent Home, Inc | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryLocations
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Avon Convalescent Home, Inc. | 5% Or Greater Direct Ownership Interest | Dec 21, 1974 | 100% |
| Freda Schwartz | Corporate Officer | Jun 29, 1983 | 100% |
| Corporate Director | Jun 29, 1983 | 100% | |
| Amy Pellerin | W-2 Managing Employee | Dec 19, 2022 | 100% |
| Operational/Managerial Control | Dec 19, 2022 | 100% | |
| Russell C Schwartz | Corporate Officer | Oct 25, 2007 | 100% |
| Corporate Director | Jun 23, 2015 | 100% |
Practitioners & affiliated clinicians
Affiliated clinicians 3
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Internal Medicine) Physician
- Farmington, CT
- NPI 1578806840
Nursing home
-
- Geriatric Medicine (Internal Medicine) Physician
- New Britain, CT
- NPI 1386888139
Nursing home
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
- Arnold M Koff, MD (Dda Avon Health
- Alexander Ashe
- Avon Allies LLC (Better Medicine Co)
- Avon Center Dentistry
- Avon Chiropractic Health Center PC (Dr Joanne A. Santiago)
- Avon Dental Group, P.C.
- Avon Eye Associates LLC (Avon Vision Associates)
- Avon Eye Care, LLC
- Avon Family and Cosmetic Dentistry LLC
- Avon Family Dentistry
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.