NPIMap

Organization Active NPI

N & R of Brookhaven LLC

Doing business as Brookhaven Nursing & Rehab

  • Skilled Nursing Facility
  • Springfield, MO
National Provider Identifier
1942607353
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
041033 Issued in MO
Legal business name
N & R OF BROOKHAVEN LLC
Doing business as
Brookhaven Nursing & Rehab
Practice address
3405 W Mount Vernon St
Springfield, MO 65802-5241
Phone
(417) 874-9600
Fax
(417) 874-9601
NPI assigned
Dec 1, 2014
Last updated
Aug 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Authorized official

Name
Carla Hedrick
Title
Chief Financial Officer
Phone
(573) 481-9625

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 041033 MO Primary

Addresses

Primary practice location

3405 W Mount Vernon St
Springfield, MO 65802-5241

Mailing address

3405 W Mount Vernon St
Springfield, MO 65802-5241
Phone (417) 874-9600

Other identifiers 1

IdentifierTypeStateIssuer
101451110MedicaidMO

Other names 1

  • BROOKHAVEN NURSING & REHAB Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150109001091 MO Part A Provider - Skilled Nursing Facility 6002130507 Practice locations: Springfield, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942607353. Details of each certification follow.

Skilled nursing facility certification: CCN 265835

Legal name
N & R OF BROOKHAVEN LLC
Doing business as
BROOKHAVEN NURSING & REHAB
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 21, 2010
Last certification
Dec 13, 2024
Beds
90
Ownership / control type
Corporation
Multi-facility organization
HEALTH SYSTEMS INC
Most recent change of ownership
Dec 1, 2014
Organization structure
LLCProprietary
Incorporated
Jul 1, 2014 in MO
Enrollment address
3405 W Mount Vernon St
Springfield, MO 65802-5241
Nursing home name
BROOKHAVEN NURSING & REHAB
Affiliated entity
JAMES & JUDY LINCOLN

Care Compare: Nursing home

Medicare Care Compare
Listed as
Brookhaven Nursing & RehabCCN 265835 · All quality measures
Overall star rating
2 of 5
Health inspections
3 of 5
Staffing
1 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Apr 21, 2010
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9052.9 residents per day on average
Chain
James & Judy Lincoln56 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Brookhaven Health and Rehabilitation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

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
Adam Knapp Individual W-2 Managing EmployeeAdministrator Apr 25, 2022 100%
LTC Management Services LLC Organization, Sikeston, MO Management services company Operational/Managerial Control Dec 1, 2014 100%
James C Lincoln Individual 5% Or Greater Direct Ownership Interest Dec 1, 2014 50%
Judy L Lincoln Individual 5% Or Greater Direct Ownership Interest Dec 1, 2014 50%

Facilities with the same owner 36

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

View all 36

Practitioners & affiliated clinicians

Practitioners 5

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.

Affiliated clinicians 1

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": "1417392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756166400000",
    "number": "1942607353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 W MOUNT VERNON ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658025241",
            "telephone_number": "417-874-9600",
            "fax_number": "417-874-9601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 W MOUNT VERNON ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658025241",
            "telephone_number": "417-874-9600",
            "fax_number": "417-874-9601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "N & R OF BROOKHAVEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-01",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A",
        "authorized_official_last_name": "HEDRICK",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "573-481-9625"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "041033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101451110",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "BROOKHAVEN NURSING & REHAB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.