Anthem Overland Park Management, LLC

Key facts

NPI

1306335328

Entity type

Organization (NPI type 2)

Primary specialty

Adult Care Home Facility 311ZA0620X

License

N046083 (KS)

Legal business name

ANTHEM OVERLAND PARK MANAGEMENT, LLC

Practice address

6921 W 81St St
Overland Park, KS 66204-3913

Phone

(913) 901-8500

Fax

(913) 901-8505

NPI assigned

May 4, 2018

Organization subpart

Yes

Parent organization (as reported)

AMC-OVERLAND PARK, LLC

Authorized official

Name

Mr. Howard J Turley, LNHA

Title

Executive Director

Phone

(913) 901-8500

Laboratory certificates & supplier records

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

CLIA laboratory certificates

National Provider Directory

Specialties & licenses

Addresses

Other names

• Morningside Place Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 4, 2018.

{
    "created_epoch": "1525392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525392000000",
    "number": "1306335328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6921 W 81ST ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662043913",
            "telephone_number": "913-901-8500",
            "fax_number": "913-901-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6921 W 81ST ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662043913",
            "telephone_number": "913-901-8500",
            "fax_number": "913-901-8505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHEM OVERLAND PARK MANAGEMENT, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMC-OVERLAND PARK, LLC",
        "enumeration_date": "2018-05-04",
        "last_updated": "2018-05-04",
        "status": "A",
        "authorized_official_last_name": "TURLEY",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "913-901-8500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "KS",
            "license": "N046083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Morningside Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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