KANSAS MASONIC HOME (NPI# 1437244654) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437244654 |
| Entity Type | Organization |
| Organization Name | KANSAS MASONIC HOME |
| Other Organization Name | KANSAS MASONIC HOME |
| Practice Address |
401 S Seneca St Wichita KS 67213-5541 |
| Practice Telephone | 3162697652 |
| Practice Fax Number | 3162697643 |
| Mailing Telephone | 3162697652 |
| Mailing Fax Number | 3162697643 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2015-07-10 |
| Authorized Official Name | MR. MATTHEW BOGNER (C.E.O.) |
| Authorized Official Telephone | 3162697650 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | N087008 | KS | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 0578 | 01 | |
| KS | 100107460A | 05 |
| Other Name | Type Code |
|---|---|
| Kansas Masonic Home | Doing Business As Name - Organization |
| Street Address |
401 S SENECA ST |
| City | WICHITA |
| State | KS |
| Zip Code | 67213-5541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952516346 | Kansas Masonic Home, Inc. | Hospice, Inpatient | 401 S Seneca St, Wichita, KS 67213-5541 | 2007-05-11 |
| 1841323573 | Kansas Masonic Home, Inc. | Assisted Living Facility | 401 S Seneca St, Wichita, KS 67213-5541 | 2007-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689111965 | Kelsey Lynn Riefenhauser | Specialist/Technologist, Other | 3100 Mccormick, Wichita, KS 67213 | 2017-01-25 |
| 1932579513 | Gracemed Health Clinic, Inc | Clinic/Center | 755 W. Lincoln St, Wichita, KS 67213 | 2015-09-25 |
| 1134564024 | Valerie Christine Wondra | Physical Therapist | 301 S Meridian Ave, Wichita, KS 67213 | 2013-05-06 |
| 1942597505 | Carmen Maria Aguilar | Social Worker | 2312 S Meridian Ave Ste 102, Wichita, KS 67213 | 2011-07-05 |
| 1245568625 | Joanne Velez | Home Health | 711 S Main, Wichita, KS 67213 | 2009-11-24 |
| 1093958712 | Adaptive Living, LLC | Occupational Therapist | 2423 W. Maple, Ste B, Wichita, KS 67213 | 2009-04-10 |
| 1295809069 | Stacey D Langston | Technician/Technologist | 2301 S Water, Wichita, KS 67213 | 2006-11-20 |
| 1275595134 | Ronald Dean Fisher | Optometrist | 2635 W Douglas, Wichita, KS 67213 | 2006-04-05 |
| 1083676936 | Wichita Optometry, P.a. | Optometrist | 2635 W Douglas Ave, Wichita, KS 67213 | 2006-04-05 |
| 1427361385 | Ryan Carl Emrick | Optometrist | 1202 W Maple St, Wichita, KS 67213 | 2010-07-21 |
| Find all providers in zip 67213 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902308919 | Center At Waterfront LLC | Skilled Nursing Facility | 1541 North Lindberg Circle, Wichita, KS 67206 | 2018-03-06 |
| 1407355720 | Kingston Trilogy Holdings LLC | Skilled Nursing Facility | 1822 N Brunswick St, Wichita, KS 67212-1588 | 2018-02-02 |
| 1881104230 | Mount St Mary Inc | Skilled Nursing Facility | 3700 E Lincoln St, Wichita, KS 67218-2008 | 2017-10-11 |
| 1154696144 | Ict 13 Snf, LLC | Skilled Nursing Facility | 10604 E 13th St N, Wichita, KS 67206-3706 | 2012-03-09 |
| 1184993156 | College Hill-ltc LLC | Skilled Nursing Facility | 5005 East 21st Street North, Wichita, KS 67208 | 2011-12-21 |
| 1053693374 | Caritas Center, Inc. | Skilled Nursing Facility | 1400 S Sheridan, Wichita, KS 67213-1336 | 2011-09-13 |
| 1457650509 | Seville Operator, LLC | Skilled Nursing Facility | 1319 Seville Street, Wichita, KS 66783-1640 | 2011-03-15 |
| 1205010303 | Family Health and Rehabilitation Center LLC | Skilled Nursing Facility | 639 South Maize Court, Wichita, KS 67209-1337 | 2007-12-26 |
| 1417139585 | Deseret Nursing and Rehabilitation At Wichita, Inc | Skilled Nursing Facility | 1600 S Woodlawn Blvd, Wichita, KS 67218-4728 | 2007-11-30 |
| 1639244536 | Lakewood Senior Living of Seville LLC | Skilled Nursing Facility | 1319 Seville St, Wichita, KS 67209-1828 | 2006-11-24 |
| Find all providers in WICHITA | ||||
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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.