NPIMap

Organization Active NPI

Cedar Lake Village, Inc

Doing business as Hoeger House

  • Skilled Nursing Facility
  • Olathe, KS
National Provider Identifier
1255345427
Registry record updated Jul 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CEDAR LAKE VILLAGE, INC
Doing business as
Hoeger House
Practice address
20911 W 153Rd St
Olathe, KS 66061
Phone
(913) 397-2900
Fax
(913) 397-2895
NPI assigned
Jul 27, 2006
Last updated
Jul 22, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2014

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

Authorized official

Name
Ms. Joanna Randall
Title
Executive Director
Phone
(913) 780-9917

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X KS Primary

Addresses

Primary practice location

20911 W 153Rd St
Olathe, KS 66061

Mailing address

20911 W 153Rd St
Olathe, KS 66061
Phone (913) 397-2900

Other names 1

  • HOEGER HOUSE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060830000291 KS Part A Provider - Skilled Nursing Facility 0143224329 Practice locations: Olathe, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255345427. Details of each certification follow.

Skilled nursing facility certification: CCN 175491

Legal name
CEDAR LAKE VILLAGE INC
Doing business as
HOEGER HOUSE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 20, 2006
Last certification
Aug 31, 2023
Beds
34
Ownership / control type
Nonprofit Corporation
Multi-facility organization
The Evangelical Lutheran Good Sam Soci
Organization structure
OtherNon-profit
Incorporated
Nov 20, 1998 in KS
Enrollment address
20911 W 153Rd St
Olathe, KS 66061-6219
Nursing home name
HOEGER HOUSE
Affiliated entity
GOOD SAMARITAN SOCIETY

Care Compare: Nursing home

Medicare Care Compare
Listed as
Hoeger HouseCCN 175491 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Oct 20, 2006
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
3427.8 residents per day on average
Chain
Good Samaritan Society92 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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
17D1062256Hoeger House20911 West 153Rd Street, Olathe, KS 66061Certificate of waiverDec 10, 2026

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

20911 W 153rd St
Olathe, KS 66061
Phone (913) 397-2900

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Cedar Lake Village Inc Organization, Olathe, KS 5% Or Greater Direct Ownership Interest Oct 20, 2006 100%
Olathe Health System, Inc. Organization, Olathe, KS Corporation, Non-profit Other Jan 1, 2019 100%
John M Bowen Individual Corporate DirectorBoard of Trustees Nov 20, 1998
Randy Fitzgerald Individual Corporate OfficerSecretary Mar 13, 2014
Corporate DirectorBoard of Trustees Jan 2, 2014
The Evangelical Lutheran Good Samaritan Society Organization, Sioux Falls, SD Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2019 50%
Thomas a Syverson Individual Corporate OfficerChairman/President Mar 13, 2014
Corporate DirectorBoard of Trustees Jan 2, 2014
Operational/Managerial ControlPresident Mar 13, 2014
Olathe Medical Center Inc Organization, Olathe, KS Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2019 50%
James K Bradley Individual Corporate DirectorBoard of Trustees Nov 20, 1998
Joseph E Herdina Individual Corporate OfficerTreasurer Dec 12, 2013
Corporate DirectorBoard of Trustee Sep 9, 2013
Sanford Organization, Fargo, ND Corporation, Non-profit Other Jan 1, 2019 100%
Alexandria Karas Individual W-2 Managing EmployeeAdministrator Nov 27, 2017

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 106

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

View all 106

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.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405987200000",
    "number": "1255345427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20911 W 153RD ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "66061",
            "telephone_number": "913-397-2900",
            "fax_number": "913-397-2895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20911 W 153RD ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "66061",
            "telephone_number": "913-397-2900",
            "fax_number": "913-397-2895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR LAKE VILLAGE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2014-07-22",
        "status": "A",
        "authorized_official_last_name": "RANDALL",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "913-780-9917",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HOEGER HOUSE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Olathe, KS

Sources for this page

Verify at the official NPI Registry.