BETHESDA LUTHERAN COMMUNITIES (NPI# 1265587356) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265587356 |
| Entity Type | Organization |
| Organization Name | BETHESDA LUTHERAN COMMUNITIES |
| Other Organization Name | BETHESDA FAITH VILLAGE |
| Practice Address |
14150 W 113th St Shawnee Mission KS 66215-4819 |
| Practice Telephone | 9139065009 |
| Practice Fax Number | 9134694028 |
| Mailing Telephone | 9139069009 |
| Mailing Fax Number | 9134694028 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2017-05-11 |
| Authorized Official Name | JEFFREY A. KACZMARSKI (CHIEF LEGAL AFFAIRS OFFICER) |
| Authorized Official Telephone | 9202064406 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | 0841302101 | KS | Agencies |
| N | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | KS | Residential Treatment Facilities | |
| Y | 310500000X | Intermediate Care Facility, Mental Illness | 1141302101 | KS | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 100045140E | 05 | |
| KS | 100108390D | 05 | |
| KS | 100045140K | 05 | |
| KS | 100108390B | 05 | |
| KS | 100045140D | 05 | |
| KS | 100108390C | 05 |
| Other Name | Type Code |
|---|---|
| Bethesda Faith Village | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538681549 | Bethesda Lutheran Communities | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 116 Thackeray Rd, Oakland, NJ 07436-3320 | 2017-07-11 |
| 1164944179 | Bethesda Lutheran Communities | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 12 Ward Witty Dr, Montville, NJ 07045-9752 | 2017-07-11 |
| 1033429683 | Bethesda Lutheran Communities | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 600 Hoffmann Dr, Watertown, WI 53094-6223 | 2010-10-18 |
| 1669618864 | Bethesda Lutheran Communities | Intermediate Care Facility, Mentally Retarded | 14150 W 113th St, Shawnee Mission, KS 66215-4819 | 2008-12-18 |
| 1780820977 | Bethesda Lutheran Communities | Intermediate Care Facility, Mentally Retarded | 14150 W 113th St, Shawnee Mission, KS 66215-4819 | 2008-12-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Bethesda Lutheran Communities Inc. | 600 Hoffmann Dr, Watertown, Wisconsin 53094-6223 |
| Oklahoma Business Registrations | BETHESDA LUTHERAN COMMUNITIES, INC. | 600 Hoffmann Dr, Watertown, WI 53094 |
| System for Award Management (SAM) Entities | BETHESDA LUTHERAN COMMUNITIES, INC. | 600 Hoffmann Dr, Watertown, WI 53094-6223 |
| Oregon Corporations, Companies and Business Names | BETHESDA LUTHERAN COMMUNITIES, INC. | 600 Hoffmann Dr, Watertown, WI 53094 |
| Iowa Business Entities | BETHESDA LUTHERAN COMMUNITIES, INC. | 600 Hoffmann Drive, Watertown, WI 53094 |
| Indiana Business Entities | BETHESDA LUTHERAN COMMUNITIES, INC. | 600 Hoffmann Drive, Watertown, WI 53094-6223 |
| Street Address |
14150 W 113TH ST |
| City | SHAWNEE MISSION |
| State | KS |
| Zip Code | 66215-4819 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669618864 | Bethesda Lutheran Communities | Intermediate Care Facility, Mentally Retarded | 14150 W 113th St, Shawnee Mission, KS 66215-4819 | 2008-12-18 |
| 1780820977 | Bethesda Lutheran Communities | Intermediate Care Facility, Mentally Retarded | 14150 W 113th St, Shawnee Mission, KS 66215-4819 | 2008-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104442193 | Breanna Kay Bezona | Chiropractor | 13830 Sante Fe Trail Dr., St. 104, Lenexa, KS 66215 | 2020-06-25 |
| 1801458542 | Paula Aileen Rogers | Registered Nurse | 14831 W 95th Street, Lenexa, KS 66215 | 2019-07-02 |
| 1154988780 | Michelle Marie Magri | Counselor | 8645 Hauser Court, Lenexa, KS 66215 | 2019-05-20 |
| 1891267100 | Beulah Mathew | Physical Therapist | Lakeview Village, 9100 Park St., Lenexa, KS 66215 | 2018-12-27 |
| 1609350123 | Courtney Smith | Behavior Technician | 9340 Gillette St., Lenexa, KS 66215 | 2018-09-20 |
| 1588182398 | Tlc Medical Transport LLC | Non-emergency Medical Transport (VAN) | 14425 College Blvd, Suite 111, Lenexa, KS 66215 | 2017-08-31 |
| 1376991091 | Abbie Elizabeth Martin | Nurse Practitioner | 1220 W. 106th Street, Suite 230, Overland Park, KS 66215 | 2016-06-03 |
| 1093199051 | Janita-jade Coffey | Nurse Practitioner | 10600 Quivira Rd Ste 320, Overland Park, KS 66215 | 2015-07-18 |
| 1518349109 | Timothy James Kamerzell | Internal Medicine | 10601 Quivira Rd Ste 200, Overland Park, KS 66215 | 2015-06-19 |
| 1245633916 | Maria Kintu | Licensed Practical Nurse | 12316 W 79th Terr, Lenexa, KS 66215 | 2014-10-08 |
| Find all providers in zip 66215 | ||||
| Taxonomy Code | 310500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mental Illness |
| A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568503878 | Brighton Place Corporation | Intermediate Care Facility, Mental Illness | 1301 Ne Jefferson St, Topeka, KS 66608-1118 | 2007-02-09 |
| 1164564340 | Community Living Opportunities | Intermediate Care Facility, Mental Illness | 11627 W 79th St, Lenexa, KS 66214-1488 | 2007-02-13 |
| 1073655254 | Community Living Opportunities | Intermediate Care Facility, Mental Illness | 11627 W 79th St, Lenexa, KS 66214-1488 | 2007-02-13 |
| 1982746160 | Community Living Opportunities | Intermediate Care Facility, Mental Illness | 11627 W 79th St, Lenexa, KS 66214-1488 | 2007-02-13 |
| 1790827970 | Community Living Opportunities | Intermediate Care Facility, Mental Illness | 11627 W 79th St, Lenexa, KS 66214-1488 | 2007-02-13 |
| 1457493637 | Community Living Opportuniteis | Intermediate Care Facility, Mental Illness | 11627 W 79th St, Lenexa, KS 66214-1488 | 2007-02-13 |
| 1366584542 | Community Living Opportunities | Intermediate Care Facility, Mental Illness | 11627 W 79th St, Lenexa, KS 66214-1488 | 2007-02-13 |
| 1316089592 | Community Living Opportunities | Intermediate Care Facility, Mental Illness | 11627 W 79th St, Lenexa, KS 66214-1488 | 2007-02-13 |
| 1225170400 | Community Living Opportunities | Intermediate Care Facility, Mental Illness | 11627 W 79th St, Lenexa, KS 66214-1488 | 2007-02-13 |
| 1134261316 | Community Living Opportunities | Intermediate Care Facility, Mental Illness | 11627 W 79th St, Lenexa, KS 66214-1488 | 2007-02-13 |
| Find all providers with the same taxonomy | ||||
| City | SHAWNEE MISSION |
| Zip Code | 66215 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.