NPIMap

Organization Active NPI

Corterra of Wichita, LLC

  • Psychiatric Hospital
  • Wichita, KS
National Provider Identifier
1245949684
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
CORTERRA OF WICHITA, LLC
Practice address
7447 W Village Cir
Wichita, KS 67205
Phone
(316) 637-2889
Fax
(316) 368-3177
NPI assigned
Nov 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Authorized official

Name
Erik Hatten
Title
Ceo/Chairman
Phone
(316) 640-8427

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X Primary

Addresses

Primary practice location

7447 W Village Cir
Wichita, KS 67205

Mailing address

7447 W Village Cir
Wichita, KS 67205
Phone (316) 637-2889

Other identifiers 1

IdentifierTypeStateIssuer
30005101960001MedicaidKS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230322002965 KS Part A Provider - Hospital 3072987692 Practice locations: Wichita, KS

Hospital certification: CCN 174026

Legal name
CORTERRA OF WICHITA LLC
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Jan 11, 2024
Last certification
Jan 11, 2024
Beds
24
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Oct 6, 2021 in KS
Enrollment address
7447 W Village Cir
Wichita, KS 67205-2625
Main/Primary Hospital Location
Hospital subgroups
Psychiatric

Care Compare: Hospital

Medicare Care Compare
Listed as
Corterra of Wichita LLCCCN 174026
Type
Psychiatric
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D2277665Corterra of Wichita, LLC7447 W Village Circle, Wichita, KS 67205Certificate of waiverMar 1, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Steven M Howard Individual 5% Or Greater Indirect Ownership Interest May 1, 2023 5.91%
Wayne C Anderson Individual 5% Or Greater Indirect Ownership Interest May 1, 2023 7.25%
Scenic Holdings LLC Organization, Overland Park, KS LLC, For-profit 5% Or Greater Direct Ownership Interest May 1, 2023 32.5%
Cadet Investment LLC Organization, Iowa Falls, IA LLC, For-profit 5% Or Greater Indirect Ownership Interest May 1, 2023 5.53%
Paul D Murray Individual 5% Or Greater Indirect Ownership Interest May 1, 2023 6.25%
Corporate DirectorBoard Member May 1, 2023 20%
Operational/Managerial ControlBoard Member May 1, 2023 50%
Corterra Healthcare Ventures, LLC Organization, Overland Park, KS LLC, For-profit 5% Or Greater Direct Ownership Interest May 1, 2023 25%
Marlene a Anderson Individual 5% Or Greater Indirect Ownership Interest May 1, 2023 7.25%
WSG LLC Organization, Overland Park, KS LLC, For-profit 5% Or Greater Direct Ownership Interest May 1, 2023 10%
5% Or Greater Indirect Ownership Interest May 1, 2023 9.38%
Poky - 5R LLC Organization, Scott City, KS LLC, For-profit 5% Or Greater Direct Ownership Interest May 1, 2023 13.92%
5% Or Greater Indirect Ownership Interest May 1, 2023 5.31%
Joseph M Morgan Individual 5% Or Greater Indirect Ownership Interest May 1, 2023 6.08%
Erik D Hatten Individual 5% Or Greater Indirect Ownership Interest May 1, 2023 6.25%
Corporate DirectorBoard Member May 1, 2023 20%
Operational/Managerial ControlBoard Member May 1, 2023 50%
Corterra Healthcare Management LLC Organization, Maize, KS LLC, For-profit Operational/Managerial Control May 1, 2023 100%
SG Fo, LLC Organization, Iowa Falls, IA LLC, For-profit 5% Or Greater Direct Ownership Interest May 1, 2023 6.16%
Scenic Development LLC Organization, Overland Park, KS LLC, For-profit 5% Or Greater Indirect Ownership Interest May 1, 2023 12.5%
Corterra Healthcare Partners LLC Organization, Maize, KS LLC, For-profit 5% Or Greater Indirect Ownership Interest May 1, 2023 12.5%

Facilities with the same owner 9

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1245949684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7447 W VILLAGE CIR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67205",
            "telephone_number": "316-637-2889",
            "fax_number": "316-368-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7447 W VILLAGE CIR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67205",
            "telephone_number": "316-637-2889",
            "fax_number": "316-368-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORTERRA OF WICHITA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-15",
        "last_updated": "2024-12-09",
        "certification_date": "2022-11-10",
        "status": "A",
        "authorized_official_last_name": "HATTEN",
        "authorized_official_first_name": "ERIK",
        "authorized_official_title_or_position": "CEO/CHAIRMAN",
        "authorized_official_telephone_number": "316-640-8427"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30005101960001",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.