Aspire Senior Living Advance, LLC
Organization Active NPI Skilled Nursing Facility · Advance, MO
NPI 1629644653 · NPPES record last updated Apr 10, 2025
Key facts
- NPI
- 1629644653
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- ASPIRE SENIOR LIVING ADVANCE, LLC
- Practice address
- 315 S Tilley St
Advance, MO 63730-7230 - Phone
- (573) 722-3440
- NPI assigned
- Jun 1, 2021
- Organization subpart
- No
Authorized official
- Name
- David Stadtmueller
- Title
- Cfo
- Phone
- (816) 957-1010
Facilities with the same owner 9
Practitioners 1
-
Angela L Patterson, M.D.
Affiliated clinicians 1
-
Angela L Patterson, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Aspire Senior Living Advance
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★★★☆☆ 3 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Nov 1, 1993
- Certified beds
- 55 · 30.7 residents per day on average
- Chain
- Aspire Senior Living
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D0673245 | Aspire Senior Living of Advance | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Skilled nursing facility certification: CCN 265550
- Legal name
- ASPIRE SENIOR LIVING ADVANCE, LLC
- Doing business as
- ASPIRE SENIOR LIVING ADVANCE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Nov 1, 1993
- Last certification
- Nov 22, 2024
- Beds
- 55
- Ownership / control type
- Corporation
- Multi-facility organization
- Aspire
- Organization structure
- LLC · Proprietary
- Incorporated
- May 17, 2021 in MO
- Enrollment address
- 315 South Tilley
Advance, MO 63730-7230 - Nursing home name
- ASPIRE SENIOR LIVING ADVANCE
- Affiliated entity
- ASPIRE SENIOR LIVING
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| Sheri L Steele |
5% Or Greater Indirect Ownership Interest | Jun 1, 2021 | 8% |
| Daniel a Brown |
Other |
Jun 1, 2021 | |
| CHP SNF Opco Holdings LLC |
5% Or Greater Direct Ownership Interest | Jun 1, 2021 | 100% |
| CHP Snfco LLC |
5% Or Greater Indirect Ownership Interest | Jun 1, 2021 | 100% |
| Michael V Brody |
5% Or Greater Indirect Ownership Interest | Jun 1, 2021 | 24.64% |
| CHP SNF Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jun 1, 2021 | 70% |
| Gregg J Calvert |
5% Or Greater Indirect Ownership Interest | Jun 1, 2021 | 12% |
| Corporate Officer |
Jun 1, 2021 | 50% | |
| W-2 Managing Employee |
Jun 1, 2021 | 50% | |
| Barbara J Brown |
Other |
Jun 1, 2021 | |
| Jerry W Harris |
5% Or Greater Indirect Ownership Interest | Jun 1, 2021 | 10% |
| Corporate Officer |
Jun 1, 2021 | 50% | |
| W-2 Managing Employee |
Jun 1, 2021 | 50% | |
| Victor S Shevlyagin |
5% Or Greater Indirect Ownership Interest | Jun 1, 2021 | 8.4% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210820002235 | MO | Part a Provider - Skilled Nursing Facility | 9032514500 | Practice locations: Advance, MO |
National Provider Directory
Locations
19401 E US Highway 40
Ste 120
Independence, MO 64055
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
315 S Tilley St
Advance, MO 63730-7230
Mailing address
19401 E US Highway 40 Ste 120
Independence, MO 64055-5400
Phone (816) 957-1010
Other names
- Aspire Senior Living Advance
Other providers in Advance, MO
- Advance Medical Clinic
- Advance Missouri Health Care
- Advance R-IV Public Schools
- John Backfisch
- Kimberly Backfisch
- Cindy Beussink
- Bits of Heaven in Home Services, LLC
- Bsap LLC
All providers in Advance, MO · Skilled Nursing Facility in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.