Ottawa Retirement Village, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NO30005 Issued in KS

Legal business name

OTTAWA RETIREMENT VILLAGE, INC.

Doing business as

Ottawa Retirement Village

Practice address

1100 W 15TH St
Ottawa, KS 66067-3953

Phone

(785) 242-5399

Fax

(785) 242-6063

NPI assigned

Aug 26, 2005

Last updated

Apr 18, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kenneth F Raupach

Title

Coo

Phone

(513) 487-3600

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Ottawa Retirement Village Doing business as

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334707200000",
    "number": "1346233038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 STRAIGHT ST",
            "address_2": "SUITE 330",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452191064",
            "telephone_number": "513-487-3600",
            "fax_number": "513-487-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W 15TH ST",
            "city": "OTTAWA",
            "state": "KS",
            "postal_code": "660673953",
            "telephone_number": "785-242-5399",
            "fax_number": "785-242-6063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTTAWA RETIREMENT VILLAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-26",
        "last_updated": "2012-04-18",
        "status": "A",
        "authorized_official_last_name": "RAUPACH",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "513-487-3600"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KS",
            "license": "NO30005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADULT CARE HOME LICENSE",
            "identifier": "NO30005",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100110980A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HCBS #",
            "identifier": "100110980B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ottawa Retirement Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Ottawa, KS
• Providers in Ottawa, KS by specialty
• Skilled Nursing Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; 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.