St Anthonys Senior Care Hospital, LLC

Primary specialty

Psychiatric HospitalTaxonomy code 283Q00000X

Legal business name

ST ANTHONYS SENIOR CARE HOSPITAL, LLC

Practice address

2114 N 127TH St E
Suite 100
Wichita, KS 67206-3003

Phone

(316) 500-8800

NPI assigned

Jan 6, 2017

Last updated

Aug 8, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

AXIOM GERI PSYCH SERVICES, LLCAs reported in NPPES

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

Authorized official

Name

Brenda Marie Kruse

Title

Cfo

Phone

(316) 448-0850

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336685932. Details of each certification follow.

• CCN 174023 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 174023

Legal name

ST ANTHONY'S SENIOR CARE HOSPITAL, LLC

Certification status

Terminated Voluntary: merger or closure, Oct 31, 2023

Provider type (POS)

Hospital – Psychiatric

Participating since

Mar 13, 2019

Last certification

Mar 13, 2019

Beds

20

Ownership / control type

Private (for profit)

Facility address

2114 N. 127TH Court East
Wichita, KS 67206

Locations

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

{
    "created_epoch": "1483660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659916800000",
    "number": "1336685932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10300 W MAPLE ST STE 5",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672093135",
            "telephone_number": "316-448-0850",
            "fax_number": "316-448-0855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 N 127TH ST E",
            "address_2": "SUITE 100",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063003",
            "telephone_number": "316-500-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST ANTHONYS SENIOR CARE HOSPITAL, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AXIOM GERI PSYCH SERVICES, LLC",
        "enumeration_date": "2017-01-06",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A",
        "authorized_official_last_name": "KRUSE",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "316-448-0850"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric Hospital in Wichita, KS
• Providers in Wichita, KS by specialty
• Psychiatric Hospital in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.