Vintage Park at Waterfront, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

VINTAGE PARK AT WATERFRONT, LLC

Practice address

900 N Bayshore Dr
Wichita, KS 67212-4807

Phone

(316) 945-3344

NPI assigned

Mar 11, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Matt Moore

Title

President

Phone

(949) 282-5800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1285804773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N BAYSHORE DR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672124807",
            "telephone_number": "316-945-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N BAYSHORE DR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672124807",
            "telephone_number": "316-945-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINTAGE PARK AT WATERFRONT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-11",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-282-5800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Barron Vincent, M.D.
• Teresa J Vincent
• Teresa M Vincent
• Shravani Vindhyal, M.D.
• Kayla Diann Vineyard, LAC
• Bethany Kristen Vinton, LMSW
• Whitney L Vinzant, MD
• Elizabeth M Viramontes, MPT
• Amaya Niccole Virden
• Vis Clinic, LLC

• Assisted Living Facility in Wichita, KS
• Providers in Wichita, 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 Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.