NPIMap

Organization Active NPI

John Knox Village

  • Community Based Hospice Care Agency
  • Lees Summit, MO
National Provider Identifier
1346337516
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
115-4HO Issued in MO
Legal business name
JOHN KNOX VILLAGE
Practice address
600 NW Pryor Rd Unit 300
Lees Summit, MO 64081-1104
Phone
(816) 525-0986
NPI assigned
Oct 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Authorized official

Name
Anthony Columbatto
Title
VP Health Services
Phone
(816) 347-2030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 115-4HO MO Primary

Addresses

Primary practice location

600 NW Pryor Rd Unit 300
Lees Summit, MO 64081-1104

Mailing address

400 NW Murray Rd
Lees Summit, MO 64081-1426

Other identifiers 1

IdentifierTypeStateIssuer
821070802MedicaidMO

Other names 1

  • Hospice by John Knox Village Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040923001055 MO Part A Provider - Hospice 5698685121 Practice locations: Lees Summit, MO

Hospice certification: CCN 261589

Legal name
JOHN KNOX VILLAGE
Doing business as
HOSPICE BY JOHN KNOX VILLAGE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Mar 22, 2002
Last certification
Aug 17, 2022
Ownership / control type
Other
Organization structure
CorporationNon-profit
Enrollment address
600 NW Pryor Rd
Unit 300
Lees Summit, MO 64081-1104

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Hospice by John Knox VillageCCN 261589
Ownership
Other
Certified
Mar 22, 2002
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Linda Harrelson Individual Corporate DirectorBoard Member Jul 1, 2021 11.1%
Charles V Robb Individual Corporate DirectorBoard Member-Vice Chair Jul 13, 2017 11.1%
Premierlife Organization, Lees Summit, MO Corporation, Non-profit Operational/Managerial Control May 11, 2006 100%
Kathryn C Twenter Individual Contracted Managing EmployeeMD; Apr 1, 2024
Michael Stoker Individual Corporate OfficerVice President-Health Services Apr 5, 2026
W-2 Managing EmployeeVice President-Health Services Jul 9, 2024
Diane Demarest Individual Corporate DirectorBoard Member Jul 1, 2021 11.1%
Tina a Smith Individual Corporate DirectorBoard Member Jul 1, 2024 11.1%
John Knox Village Organization, Lees Summit, MO Corporation, Non-profit 5% Or Greater Direct Ownership Interest Oct 29, 2001 100%
Timothy Dykman Individual Corporate DirectorBoard Member Aug 6, 2025 11.1%
Maria T Timberlake Individual Corporate OfficerVice-President Jul 13, 2017 25%
Anthony M Columbatto Individual Corporate OfficerPresident Jul 1, 2025
Steven M Seggerman Individual Corporate OfficerVice President-Finance May 2, 2025 25%
Carl Chinnery Individual Corporate DirectorBoard Member Jul 1, 2021 11.1%
Gabriel Clements Individual Corporate DirectorBoard Member Jul 1, 2021 11.1%
Laurie Johnson Individual Corporate OfficerVice President-Human Resources Jul 13, 2017 25%
James Ham Individual Corporate DirectorBoard Member-Secretary Jul 1, 2021 11.1%
Melvin Gross Individual Corporate DirectorBoard Member-Chair Jul 1, 2021 11.1%

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
John Knox Village Care CenterLees Summit, MO, CCN 265095 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)
Adp of the SNF
Direct Ownership Interest (100%)		 Feb 1, 1974
Feb 1, 1974
Feb 1, 1974
Feb 1, 1974
Home Health by John Knox VillageLees Summit, MO, CCN 267056 Home health agency 5% Or Greater Direct Ownership Interest (100%) Feb 1, 1974

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • John Knox Village
    • Skilled Nursing Facility
    • Lees Summit, MO
    • NPI 1023005592

    5% Or Greater Direct Ownership Interest, Adp of the SNF, Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • John Knox Village
    • Home Health Agency
    • Lees Summit, MO
    • NPI 1770587040

    5% Or Greater Direct Ownership Interest

    CMS ownership

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

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": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735171200000",
    "number": "1346337516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 NW MURRAY RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640811426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NW PRYOR RD UNIT 300",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640811104",
            "telephone_number": "816-525-0986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN KNOX VILLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-17",
        "status": "A",
        "authorized_official_last_name": "COLUMBATTO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "VP HEALTH SERVICES",
        "authorized_official_telephone_number": "816-347-2030"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MO",
            "license": "115-4HO",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "821070802",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hospice by John Knox Village",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hospice by John Knox Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lees Summit, MO

Sources for this page

Verify at the official NPI Registry.