NPIMap

Organization Active NPI

Parkway Health Care Center, L.L.C.

  • Skilled Nursing Facility
  • Kansas City, MO
National Provider Identifier
1295189645
Registry record updated Apr 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PARKWAY HEALTH CARE CENTER, L.L.C.
Practice address
2323 Swope Pkwy
Kansas City, MO 64130-2638
Phone
(816) 924-1122
Fax
(816) 924-0955
NPI assigned
Apr 21, 2016
Last updated
Apr 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2016

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

Authorized official

Name
Mr. Robert J Craddick
Title
In-House Counsel
Phone
(314) 543-3816

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

2323 Swope Pkwy
Kansas City, MO 64130-2638

Mailing address

1869 Craig Park CT
Saint Louis, MO 63146-4122
Phone (314) 543-3816

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160713002393 MO Part A Provider - Skilled Nursing Facility 7911299805 Practice locations: Kansas City, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295189645. Details of each certification follow.

Skilled nursing facility certification: CCN 265532

Legal name
PARKWAY HEALTH CARE CENTER LLC
Doing business as
PARKWAY HEALTH CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 1, 1993
Last certification
Oct 23, 2024
Beds
97
Ownership / control type
Corporation
Multi-facility organization
RELIANT HEALTHCARE MANAGEMENT
Most recent change of ownership
Jun 1, 2016
Organization structure
LLCProprietary
Enrollment address
2323 Swope Pkwy
Kansas City, MO 64130-2638
Nursing home name
PARKWAY HEALTH CARE CENTER
Affiliated entity
RELIANT CARE MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Parkway Health Care CenterCCN 265532 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
1 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Apr 1, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9763.0 residents per day on average
Chain
Reliant Care Management34 facilities in the chain
Penalties (3 years)
2Fines totaling $30,821

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
26D0444240Parkway Health Care Center2323 Swope Pkwy, Kansas City, MO 64130Certificate of waiverAug 31, 2026
26D2342451Ama at Parkway Health Care Center2323 Swope Parkway, Suite 001, Kansas City, MO 64130Certificate of waiverApr 20, 2028

National Provider Directory

National Provider Directory
Tax ID family
Parkway Health and Rehab2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Justin Honderick Individual Operational/Managerial Control Jun 17, 2025
Adp of the SNF Jun 17, 2025
RCG Inc Organization, Saint Louis, MO Corporation, Holding company, Owned by another organization or individual Indirect Ownership Interest Jun 1, 2016 0.01%
Richard J. Destefane Revocable Living Trust Organization, Saint Louis, MO Indirect Ownership Interest Mar 1, 2018 100%
Richard J Destefane Individual Operational/Managerial Control Jun 1, 2016
Adp of the SNF Mar 1, 2018
Indirect Ownership Interest Mar 1, 2018 100%
Reliant Care Group LLC Organization, Saint Louis, MO LLC, Holding company, Owned by another organization or individual Direct Ownership Interest Jun 1, 2016 100%
TLG II LLP Organization, Saint Louis, MO Holding company Adp of the SNF Jun 1, 2016
Reliant Care Management Company LLC Organization, Saint Louis, MO LLC, Management services company, Chain home office Operational/Managerial Control Jun 1, 2016
Adp of the SNF Apr 28, 2025
KC Manor Associates, L.L.C. Organization, Saint Louis, MO LLC Adp of the SNF Jun 1, 2016
Abdullah Arshad Individual Operational/Managerial Control Sep 15, 2024
Adp of the SNF Sep 15, 2024

Owners & managing parties with NPI records 1

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

Facilities with the same owner 32

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

View all 32

Practitioners & affiliated clinicians

Practitioners 4

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": "1461196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461196800000",
    "number": "1295189645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1869 CRAIG PARK CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631464122",
            "telephone_number": "314-543-3816",
            "fax_number": "314-543-3880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 SWOPE PKWY",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641302638",
            "telephone_number": "816-924-1122",
            "fax_number": "816-924-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKWAY HEALTH CARE CENTER, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-21",
        "last_updated": "2016-04-21",
        "status": "A",
        "authorized_official_last_name": "CRADDICK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "IN-HOUSE COUNSEL",
        "authorized_official_telephone_number": "314-543-3816",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.