NPIMap

Organization Active NPI

Brookdale Senior Living Communities, Inc.

Doing business as Brookdale Dodge City

  • Assisted Living Facility
  • Dodge City, KS
National Provider Identifier
1396801916
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
BROOKDALE SENIOR LIVING COMMUNITIES, INC.
Doing business as
Brookdale Dodge City
Practice address
2400 N 14TH Ave
Dodge City, KS 67801-2370
Phone
(620) 225-7555
NPI assigned
Dec 28, 2006
Last updated
Dec 3, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
BROOKDALE SENIOR LIVING INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Authorized official

Name
Joanne K Leskowicz
Title
Senior Vice President
Phone
(414) 918-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

2400 N 14TH Ave
Dodge City, KS 67801-2370

Mailing address

2400 N 14TH Ave
Dodge City, KS 67801-2370
Phone (620) 225-7555

Other identifiers 1

IdentifierTypeStateIssuer
100382540 NMedicaidKS

Other names 1

  • Brookdale Dodge City Doing business as

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
17D0971444Brookdale Dodge City2400 N 14TH Ave, Dodge City, KS 67801Certificate of waiverMar 13, 2028

National Provider Directory

National Provider Directory
Tax ID family
Brookdale Senior Living Communities Inc248 organizations share this tax ID, including this one
Part of
Brookdale Senior Living Inc

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606953600000",
    "number": "1396801916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 N 14TH AVE",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678012370",
            "telephone_number": "620-225-7555",
            "fax_number": "620-225-6714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 N 14TH AVE",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678012370",
            "telephone_number": "620-225-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKDALE SENIOR LIVING COMMUNITIES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROOKDALE SENIOR LIVING INC",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A",
        "authorized_official_last_name": "LESKOWICZ",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "414-918-5000"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100382540 N",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Dodge City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dodge City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.