NPIMap

Organization Active NPI

Coffey County Hospital LTC

Doing business as Sunset Manor

  • Nursing Facility/Intermediate Care Facility
  • Waverly, KS
National Provider Identifier
1073603825
Registry record updated Jan 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
Legal business name
COFFEY COUNTY HOSPITAL LTC
Doing business as
Sunset Manor
Practice address
128 S Pearson Avenue
Waverly, KS 66871
Phone
(785) 733-2744
Fax
(785) 733-2514
NPI assigned
Oct 13, 2006
Last updated
Jan 15, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
COFFEY COUNTY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 15, 2019

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

Authorized official

Name
Merri Michaels
Title
Billing Supervisor
Phone
(620) 364-2121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X KS Primary

Addresses

Primary practice location

128 S Pearson Avenue
Waverly, KS 66871

Mailing address

801 N 4TH St
Burlington, KS 66839-2602
Phone (620) 364-2121

Other identifiers 1

IdentifierTypeStateIssuer
100110550AMedicaidKS

Other names 1

  • Sunset Manor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Coffey Co Hosp Amb9 organizations share this tax ID, including this one
Part of
Coffey Co Hosp Amb

Other organizations with this tax ID 8

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

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547510400000",
    "number": "1073603825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 N 4TH ST",
            "city": "BURLINGTON",
            "state": "KS",
            "postal_code": "668392602",
            "telephone_number": "620-364-2121",
            "fax_number": "620-364-8425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 S PEARSON AVENUE",
            "city": "WAVERLY",
            "state": "KS",
            "postal_code": "66871",
            "telephone_number": "785-733-2744",
            "fax_number": "785-733-2514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COFFEY COUNTY HOSPITAL LTC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COFFEY COUNTY HOSPITAL",
        "enumeration_date": "2006-10-13",
        "last_updated": "2019-01-15",
        "status": "A",
        "authorized_official_last_name": "MICHAELS",
        "authorized_official_first_name": "MERRI",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "620-364-2121"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100110550A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunset Manor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sunset Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waverly, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.