Lakeside Terrace

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

N066007 Issued in KS

Legal business name

LAKESIDE TERRACE

Practice address

1100 Harrison
Sabetha, KS 66534

Phone

(785) 284-3471

Fax

(785) 284-3697

NPI assigned

Mar 3, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ed J Strahm

Title

Administrator

Phone

(785) 284-3471

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124095534. Details of each certification follow.

• CCN 17G068 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 17G068

Legal name

LAKESIDE TERRACE

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Apr 18, 1991

Last certification

Sep 24, 2025

Beds

12

Ownership / control type

Private (non-profit)

Facility address

1100 Harrison Street
Sabetha, KS 66534

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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.

• Rachel Allen

  • Family Medicine Physician
  • Sabetha, KS
  • NPI 1619400207
  NPD (past)
• Kevin P. Kennally, M.D.

  • Family Medicine Physician
  • Sabetha, KS
  • NPI 1487683900
  NPD (past)

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124095534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 PARAMOUNT ST",
            "city": "SABETHA",
            "state": "KS",
            "postal_code": "66534",
            "telephone_number": "785-284-3471",
            "fax_number": "785-284-3697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 HARRISON",
            "city": "SABETHA",
            "state": "KS",
            "postal_code": "66534",
            "telephone_number": "785-284-3471",
            "fax_number": "785-284-3697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE TERRACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STRAHM",
        "authorized_official_first_name": "ED",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "785-284-3471",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "KS",
            "license": "N066007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Colleen Henry, CPTA
• Kansas Dialysis Services LC
• Kevin P. Kennally, M.D.
• Randall J Kirwan, D.D.S.
• Paula Koch, RPH
• Lemons Therapy LLC
• Rachel Lemons, DPT
• Lisa Elaine Lierz, R.PH
• James Allen Longabaugh, D.O.
• Susan Rose Lueger, APRN

• Intellectual Disabilities Intermediate Care Facility in Sabetha, KS
• Providers in Sabetha, KS by specialty
• Intellectual Disabilities Intermediate Care Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.

Verify at the official NPI Registry.