Active NPI
Bethany Home Association of Lindsborg Kansas
- Nursing Facility/Intermediate Care Facility
- Lindsborg, KS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- License
- 100108780A
- Legal business name
- BETHANY HOME ASSOCIATION OF LINDSBORG KANSAS
- Practice address
- 321 N Chestnut St
Lindsborg, KS 67456-1904 - Phone
- (785) 227-2892
- Fax
- (785) 227-3138
- NPI assigned
- Aug 24, 2005
- Last updated
- Sep 8, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Marlin Johnson
- Title
- Administrator
- Phone
- (785) 227-2892
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | 100108780A | KS | Primary |
Addresses
Primary practice location
321 N Chestnut St
Lindsborg, KS 67456-1904
Mailing address
321 N Chestnut St
Lindsborg, KS 67456-1904
Phone (785) 227-2892
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1041589001 | Medicaid | KS |
Other names 1
- Bethany Home Association
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080829000558 | KS | Part A Provider - Skilled Nursing Facility | 7719940162 | Practice locations: Lindsborg, KS |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1033102165. Details of each certification follow.
Skilled nursing facility certification: CCN 175507
- Legal name
- BETHANY HOME ASSOCIATION OF LINDSBORG KANSAS
- Doing business as
- BETHANY HOME ASSOCIATION
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Sep 29, 2008
- Last certification
- Aug 14, 2024
- Beds
- 100 (85 certified)
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Incorporated
- Jun 14, 1973 in KS
- Enrollment address
- 321 N Chestnut St
Lindsborg, KS 67456-1904 - Nursing home name
- BETHANY HOME ASSOCIATION
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Bethany Home Association
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Sep 29, 2008
- Medicare certification status
- Active
- Certified beds
- 85
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 17D0662529 | Bethany Home Association of Lindsborg Kansas | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 6
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Kriston Erickson | Corporate Officer | Sep 15, 2014 | |
| Operational/Managerial Control | Sep 15, 2014 | ||
| Melissa Brumbaugh | Corporate Officer | Dec 8, 2021 | |
| Ken Cummings | Corporate Director | Oct 26, 2021 | |
| Galen Swenson | Corporate Director | Oct 26, 2021 | |
| Amy Truhe | Corporate Director | Feb 26, 2019 | |
| Karen Carlson | Corporate Director | Oct 26, 2021 |
Practitioners & affiliated clinicians
Practitioners 3
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.
-
- Family Medicine Physician
- Lindsborg, KS
- NPI 1730400219
-
- Family Medicine Physician
- Lindsborg, KS
- NPI 1588697114
-
- Family Medicine Physician
- Kingman, KS
- NPI 1083714380
Affiliated clinicians 6
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": "1124841600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1220832000000",
"number": "1033102165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "321 N CHESTNUT ST",
"city": "LINDSBORG",
"state": "KS",
"postal_code": "674561904",
"telephone_number": "785-227-2892",
"fax_number": "785-227-3138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "321 N CHESTNUT ST",
"city": "LINDSBORG",
"state": "KS",
"postal_code": "674561904",
"telephone_number": "785-227-2892",
"fax_number": "785-227-3138"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BETHANY HOME ASSOCIATION OF LINDSBORG KANSAS",
"organizational_subpart": "NO",
"enumeration_date": "2005-08-24",
"last_updated": "2008-09-08",
"status": "A",
"authorized_official_last_name": "JOHNSON",
"authorized_official_first_name": "MARLIN",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "785-227-2892",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "KS",
"license": "100108780A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1041589001",
"state": "KS"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Bethany Home Association",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Lindsborg, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.