Vintage Park at Osage City, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

VINTAGE PARK AT OSAGE CITY, LLC

Practice address

1403 Laing St
Osage City, KS 66523-9203

Phone

(785) 528-5095

Fax

(785) 528-4867

NPI assigned

Aug 29, 2008

Organization subpart

No

Name

Mr. Matt Moore

Title

President

Phone

(949) 282-5800

• Vintage Park at Osage City Other name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 29, 2008.

{
    "created_epoch": "1219968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219968000000",
    "number": "1093963225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 LAING ST",
            "city": "OSAGE CITY",
            "state": "KS",
            "postal_code": "665239203",
            "telephone_number": "785-528-5095",
            "fax_number": "785-528-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 LAING ST",
            "city": "OSAGE CITY",
            "state": "KS",
            "postal_code": "665239203",
            "telephone_number": "785-528-5095",
            "fax_number": "785-528-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINTAGE PARK AT OSAGE CITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-29",
        "last_updated": "2008-08-29",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-282-5800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BEING APPLIED FOR",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vintage Park at Osage City",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Teresa Barker Sturm, RPT
• Carter Swindale, DPT
• Kevin Alan Swindale, CPTA
• Elton Laverne Taylor, D.C.
• Techs Inc
• Jodi L Wulfkuhle, APRN

• All providers in Osage City, KS
• Assisted Living Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; 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.