NPIMap

Organization Active NPI

Johnson County Rehabilitation Hospital, LLC

  • Rehabilitation Hospital
  • Overland Park, KS
National Provider Identifier
1306589890
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
Legal business name
JOHNSON COUNTY REHABILITATION HOSPITAL, LLC
Practice address
11325 College Boulevard
Overland Park, KS 66210
Phone
(480) 801-6700
NPI assigned
Apr 14, 2022
Last updated
Oct 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Authorized official

Name
Tracey Nixon
Title
Chief Compliance Officer
Phone
(469) 640-6503

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X Primary

Addresses

Primary practice location

11325 College Boulevard
Overland Park, KS 66210

Mailing address

450 Century Pkwy Ste 220
Allen, TX 75013-8135
Phone (469) 640-6503

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other CMS HIH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220613000160 KS Part A Provider - Hospital 0143608687 Practice locations: Overland Park, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306589890. Details of each certification follow.

Hospital certification: CCN 173034

Legal name
JOHNSON COUNTY REHABILITATION HOSPITAL, LLC
Certification status
Active
Provider type (POS)
Hospital – Rehabilitation
Participating since
Aug 27, 2022
Last certification
Aug 27, 2022
Beds
40
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Enrollment address
11325 College Blvd
Overland Park, KS 66210-2804
Main/Primary Hospital Location
Hospital subgroups
Rehabilitation unit

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Johnson County Rehabilitation Hospital, LLCCCN 173034 · All quality measures
Ownership
For profit
Certified
Aug 27, 2022
Medicare certification status
ActiveFrom the Provider of Services file

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
17D2263204Johnson County Rehabilitation Hospital, LLC11325 College Blvd, Overland Park, KS 66210Certificate of waiverJun 23, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Tracey Nixon Individual Corporate Officer May 23, 2022
Nepi, LLC Organization, Grapevine, TX LLC 5% Or Greater Indirect Ownership Interest May 23, 2022 6%
Daryn Eudaly Individual 5% Or Greater Indirect Ownership Interest May 23, 2022 22.79%
Alex Bennett Individual 5% Or Greater Indirect Ownership Interest May 23, 2022 8.39%
Nesi, LLC Organization, Grapevine, TX LLC 5% Or Greater Indirect Ownership Interest May 23, 2022 6%
SPC Capital, Inc. Organization, Grapevine, TX Corporation 5% Or Greater Indirect Ownership Interest Jul 28, 2025 27.21%
New Era Companies, LLC Organization, Grapevine, TX LLC 5% Or Greater Indirect Ownership Interest May 23, 2022 54.42%
Nec Rhi, LLC Organization, Grapevine, TX LLC 5% Or Greater Indirect Ownership Interest May 23, 2022 27.59%
Krista Jackson Individual W-2 Managing Employee May 23, 2022
WB Development Holdings, LLC Organization, Irving, TX LLC 5% Or Greater Indirect Ownership Interest May 23, 2022 33.58%
Nobis Rehabilitation Partners, LLC Organization, Lucas, TX LLC Operational/Managerial Control May 23, 2022
Newera Nobis Operations Holdings, LLC Organization, Grapevine, TX LLC 5% Or Greater Direct Ownership Interest May 23, 2022 100%
Nobis Hospital Investments, LLC Organization, Lucas, TX LLC 5% Or Greater Indirect Ownership Interest May 23, 2022 6%
Ahac Investments, LLC Organization, Irving, TX LLC 5% Or Greater Indirect Ownership Interest May 23, 2022 8.39%
Newera Irf Holdings, LLC Organization, Grapevine, TX LLC 5% Or Greater Indirect Ownership Interest May 23, 2022 100%
Karen Macy Schepis Individual Corporate DirectorCorporate Director of Compliance May 2, 2023
Nobis Rehabilitation Holdings, LLC Organization, Lucas, TX LLC 5% Or Greater Indirect Ownership Interest May 23, 2022 6%
Margie Crawley Individual Corporate DirectorCorporate Director of Rev Cycle May 2, 2023
Chester W Crouch Individual Corporate Officer May 23, 2022
Operational/Managerial ControlCeo May 23, 2022
Irf JV Investors, LLC Organization, Grapevine, TX LLC 5% Or Greater Indirect Ownership Interest May 23, 2022 6%

Facilities with the same owner 15

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

View all 15

Practitioners & affiliated clinicians

Practitioners 3

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 4

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": "1649894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1306589890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CENTURY PKWY STE 220",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750138135",
            "telephone_number": "469-640-6503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11325 COLLEGE BOULEVARD",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66210",
            "telephone_number": "480-801-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON COUNTY REHABILITATION HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-14",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A",
        "authorized_official_last_name": "NIXON",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "469-640-6503"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "CMS HIH",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "7500 Security Blvd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212441849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.