Active NPI
Leonardville Nursing Home, Inc
- Skilled Nursing Facility
- Leonardville, KS
National Provider Identifier
1265446041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- N-081-002
- Legal business name
- LEONARDVILLE NURSING HOME, INC
- Practice address
- 409 W Barton Rd
Leonardville, KS 66449-2023 - Phone
- (785) 293-5244
- Fax
- (785) 293-5574
- NPI assigned
- Jul 28, 2006
- Last updated
- Mar 12, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Glenda Brenner
- Title
- Adm. Assist.
- Phone
- (785) 293-5244
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | N-081-002 | KS | Primary |
Addresses
Primary practice location
409 W Barton Rd
Leonardville, KS 66449-2023
Mailing address
PO Box 148
Leonardville, KS 66449-0148
Phone (785) 293-5244
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100023180A | Other | KS | ADULT DAY CARE |
| 100108870A | Medicaid | KS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040721001663 | KS | Part A Provider - Skilled Nursing Facility | 9436139342 | Practice locations: Leonardville, KS |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1265446041. Details of each certification follow.
Skilled nursing facility certification: CCN 175477
- Legal name
- LEONARDVILLE NURSING HOME INC
- Doing business as
- LEONARDVILLE NURSING HOME
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 30, 2004
- Last certification
- Oct 31, 2024
- Beds
- 55
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Enrollment address
- 409 W Barton Rd
Leonardville, KS 66449-2023 - Nursing home name
- LEONARDVILLE NURSING HOME
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Leonardville Nursing Home
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Jun 30, 2004
- Medicare certification status
- Active
- Certified beds
- 55
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 17D0674354 | Leonardville Nursing Home | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 4
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Deanna Adkins | Corporate Director | Apr 30, 2020 | |
| Heather Germann | Corporate Director | Mar 22, 2023 | 100% |
| W-2 Managing Employee | Mar 22, 2023 | 100% | |
| Adp of the SNF | Nov 7, 2024 | ||
| Leonardville Nursing Home Inc | 5% Or Greater Direct Ownership Interest | May 4, 1966 | 100% |
| 5% Or Greater Security Interest | May 4, 1966 | 100% | |
| Operational/Managerial Control | May 4, 1966 | 100% | |
| Dwight Baer | Corporate Director | Apr 30, 2021 |
Practitioners & affiliated clinicians
Affiliated clinicians 8
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": "1154044800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1331510400000",
"number": "1265446041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 148",
"city": "LEONARDVILLE",
"state": "KS",
"postal_code": "664490148",
"telephone_number": "785-293-5244",
"fax_number": "785-293-5574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409 W BARTON RD",
"city": "LEONARDVILLE",
"state": "KS",
"postal_code": "664492023",
"telephone_number": "785-293-5244",
"fax_number": "785-293-5574"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LEONARDVILLE NURSING HOME, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-28",
"last_updated": "2012-03-12",
"status": "A",
"authorized_official_last_name": "BRENNER",
"authorized_official_first_name": "GLENDA",
"authorized_official_title_or_position": "ADM. ASSIST.",
"authorized_official_telephone_number": "785-293-5244",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "KS",
"license": "N-081-002",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ADULT DAY CARE",
"identifier": "100023180A",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100108870A",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Leonardville, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2012; 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.