NPIMap

Organization Active NPI

The Christian & Missionary Alliance Foundation Inc

Doing business as Shell Point Nursing Pavilion

  • Skilled Nursing Facility
  • Fort Myers, FL
National Provider Identifier
1669546321
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
THE CHRISTIAN & MISSIONARY ALLIANCE FOUNDATION INC
Doing business as
Shell Point Nursing Pavilion
The Larsen Health Center
Practice address
13880 Shell Point PLZ Ste 200
Fort Myers, FL 33908-3504
Phone
(239) 454-2041
Fax
(239) 454-2224
NPI assigned
Nov 17, 2006
Last updated
Mar 29, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
THE CHRISTIAN AND MISSIONARY ALLIANCE FOUNDATION INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Authorized official

Name
Tasha Marie Vassar
Title
Medical Billing Manager
Phone
(239) 433-7937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

13880 Shell Point PLZ Ste 200
Fort Myers, FL 33908-3504

Mailing address

15000 Shell Point Blvd
Suite#100
Fort Myers, FL 33908-1637
Phone (239) 454-2146

Other practice location 1

15071 Shell Point Blvd
Fort Myers, FL 33908-1639
Phone (239) 454-2146

Other identifiers 2

IdentifierTypeStateIssuer
=========OtherFLTAX ID# (EIN)
022920200MedicaidFL

Other names 2

  • Shell Point Nursing Pavilion Doing business as
  • The Larsen Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100220000036 FL Part A Provider - Skilled Nursing Facility 9739072232 Practice locations: Fort Myers, FL
O20140819001276 FL Part B Supplier - Clinic/Group Practice 2860619632 Receives reassigned benefits from 588 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669546321. Details of each certification follow.

Skilled nursing facility certification: CCN 105966

Legal name
THE CHRISTIAN & MISSIONARY ALLIANCE FOUNDATION, INC
Doing business as
SHELL POINT - LARSEN PAVILION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 4, 1997
Last certification
May 22, 2025
Beds
180
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 23, 1967 in FL
Enrollment address
13880 Shell Point PLZ
Fort Myers, FL 33908-3503
Nursing home name
LARSEN HEALTH CENTER
Affiliated entity
THE CHRISTIAN AND MISSIONARY ALLIANCE

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Larsen Health CenterCCN 105966 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Aug 4, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
180152.8 residents per day on average
Chain
The Christian and Missionary Alliance2 facilities in the chain
Penalties (3 years)
1Fines totaling $32,139

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
10D0980263Larsen Health Center13880 Shell Point Plaza, Suite 200, Fort Myers, FL 33908Certificate of waiverNov 15, 2026

National Provider Directory

National Provider Directory
Tax ID family
The Christian Missionary a6 organizations share this tax ID, including this one
Part of
The Christian Missionary a

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

15071 Shell Point Blvd
Fort Myers, FL 33908
Phone (239) 415-5432

Ownership & related parties

All disclosed owners & managing parties 24

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

NameRoleSinceShare
Archie White Individual Corporate DirectorBoard Member Jan 1, 2008
Staffmd, LLC Organization, Alpharetta, GA Medical staffing company Adp of the SNF Jan 7, 2025
Chanley Christman Individual Corporate DirectorBoard Member May 1, 2011
Jay Hibbard Individual Corporate DirectorBoard Member Oct 1, 2009
Henry B Huisman Individual Operational/Managerial Control Mar 31, 2025
Adp of the SNF Mar 31, 2025
Mark Ofarrell Individual Corporate DirectorBoard Member Jan 1, 1994
Martin Schappell Individual Corporate OfficerPresident and Ceo Mar 21, 2016
Operational/Managerial Control Mar 21, 2016
The Christian and Missionary Alliance Organization, Colorado Springs, CO Non-profit 5% Or Greater Indirect Ownership Interest Jun 1, 1972 100%
Adp of the SNF Mar 23, 1967
John Davidson Individual Corporate DirectorBoard Member Nov 1, 1995
Jeremy Dys Individual Corporate DirectorBoard Member Jan 1, 2020
Ken Baldes Individual Corporate DirectorBoard Member Jan 1, 2001
Tom Flanders Individual Corporate DirectorBoard Member Jan 1, 2022
Lewis Rainey Individual Corporate OfficerCfo Jan 6, 2020
Operational/Managerial Control Jan 6, 2020
Michael Scales Individual Corporate DirectorBoard Member Nov 1, 2002
Michele a Candelore Individual Corporate DirectorMedical Director Oct 1, 2024
Operational/Managerial Control Oct 1, 2024
Adp of the SNF Jul 31, 2025
Charles Dewitt Individual Corporate DirectorBoard Member Jan 1, 1990
Paul Cass Individual Corporate DirectorBoard Member Jan 1, 2002
Aegis Therapies, Inc. Organization, Frisco, TX Corporation Adp of the SNF Oct 1, 2021
James D Glenn Individual Corporate DirectorBoard Member Jan 1, 1991
Jon P Burdzy Individual Corporate DirectorBoard Member Jan 1, 2020
Donna Duss Individual Corporate DirectorBoard Member Jan 1, 1994
Tasha M Vassar Individual Corporate DirectorAuthorized Official Jun 4, 2017
Polaris Health LLC Organization, Chicago, IL LLC Adp of the SNF Mar 25, 2025
Wanda Anderson Individual Corporate DirectorBoard Member Jan 1, 2008

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Shell Point Home HealthFort Myers, FL, CCN 687083 Home health agency 5% Or Greater Direct Ownership Interest (100%)
5% Or Greater Mortgage Interest (13.2%)
5% Or Greater Security Interest (14.9%)
Other (100%)		 May 30, 2019
Jul 10, 2019
Sep 9, 2016
Mar 23, 1967

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

Affiliated clinicians 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648512000000",
    "number": "1669546321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15000 SHELL POINT BLVD",
            "address_2": "SUITE#100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339081637",
            "telephone_number": "239-454-2146",
            "fax_number": "239-454-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13880 SHELL POINT PLZ STE 200",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083504",
            "telephone_number": "239-454-2041",
            "fax_number": "239-454-2224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15071 Shell Point Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339081639",
            "country_code": "US",
            "telephone_number": "239-454-2146",
            "fax_number": "239-454-2111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE CHRISTIAN & MISSIONARY ALLIANCE FOUNDATION INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE CHRISTIAN AND MISSIONARY ALLIANCE FOUNDATION INC",
        "enumeration_date": "2006-11-17",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A",
        "authorized_official_last_name": "VASSAR",
        "authorized_official_first_name": "TASHA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "MEDICAL BILLING MANAGER",
        "authorized_official_telephone_number": "239-433-7937"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID# (EIN)",
            "identifier": "=========",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022920200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shell Point Nursing Pavilion",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Larsen Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Larsen Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.