Homestead of El Dorado Operations LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

N008009 Issued in KS

Legal business name

HOMESTEAD OF EL DORADO OPERATIONS LLC

Practice address

1650 E 12TH Ave
El Dorado, KS 67042-4300

Phone

(316) 321-7777

Fax

(316) 321-6115

NPI assigned

Jan 3, 2017

Organization subpart

No

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

Authorized official

Name

Michael D Tryon, CPA

Title

Cfo

Phone

(785) 272-1535

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• El Dorado Homestead Doing business as

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

CLIA laboratory certificates

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

{
    "created_epoch": "1483401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483401600000",
    "number": "1275078065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 E 12TH AVE",
            "city": "EL DORADO",
            "state": "KS",
            "postal_code": "670424300",
            "telephone_number": "316-321-7777",
            "fax_number": "316-321-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 E 12TH AVE",
            "city": "EL DORADO",
            "state": "KS",
            "postal_code": "670424300",
            "telephone_number": "316-321-7777",
            "fax_number": "316-321-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMESTEAD OF EL DORADO OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-03",
        "last_updated": "2017-01-03",
        "status": "A",
        "authorized_official_last_name": "TRYON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "785-272-1535",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "KS",
            "license": "N008009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N008009",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "El Dorado Homestead",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in El Dorado, KS
• Providers in El Dorado, KS by specialty
• Assisted Living Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.