NPIMap

Organization Active NPI

Restoration Health Care LLC

  • Skilled Nursing Facility
  • Wichita, KS
National Provider Identifier
1184109803
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
RESTORATION HEALTH CARE LLC
Practice address
1541 N Lindberg Cir
Wichita, KS 67206-6400
Phone
(316) 258-5882
NPI assigned
Sep 27, 2018
Last updated
Feb 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Authorized official

Name
Jessica Manzano
Title
Director of Revenue Cycle
Phone
(316) 312-7780

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

1541 N Lindberg Cir
Wichita, KS 67206-6400

Mailing address

12300 E Four Oaks St
Wichita, KS 67226-8366

Other identifiers 1

IdentifierTypeStateIssuer
201281390AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190118001615 KS Part B Supplier - Clinic/Group Practice 2567708142 Receives reassigned benefits from 12 practitioners
Practice locations: Wichita, KS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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": "1538006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613433600000",
    "number": "1184109803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12300 E FOUR OAKS ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672268366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 N LINDBERG CIR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672066400",
            "telephone_number": "316-258-5882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATION HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-27",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A",
        "authorized_official_last_name": "MANZANO",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "316-312-7780"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201281390A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.