NPIMap

Organization Active NPI

Southwest Medical Center

Doing business as Skilled Nursing Facility

  • Skilled Nursing Facility
  • Liberal, KS
National Provider Identifier
1407890692
Registry record updated Dec 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
175163 Issued in KS
Legal business name
SOUTHWEST MEDICAL CENTER
Doing business as
Skilled Nursing Facility
Practice address
315 W 15TH St
Liberal, KS 67901-2455
Phone
(620) 624-1651
Fax
(620) 629-2472
NPI assigned
Jun 16, 2006
Last updated
Dec 12, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHWEST MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 12, 2014

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

Authorized official

Name
Mr. William Ermann
Title
Ceo/Administrator
Phone
(620) 629-6400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 175163 KS Primary

Addresses

Primary practice location

315 W 15TH St
Liberal, KS 67901-2455

Mailing address

315 W 15TH Street
PO Box 1340
Liberal, KS 67905-1340
Phone (620) 624-1651

Other names 1

  • Skilled Nursing Facility Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040616000785 KS Part A Provider - Skilled Nursing Facility 7517941651 Practice locations: Liberal, KS
O20040805001105 KS Part B Supplier - Clinic/Group Practice 7517941651 Receives reassigned benefits from 80 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Meade, KS; Liberal, KS; Johnson, KS; Hugoton, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407890692. Details of each certification follow.

Skilled nursing facility certification: CCN 175163

Legal name
SOUTHWEST MEDICAL CENTER
Doing business as
SOUTHWEST MEDICAL CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Jul 31, 1987
Last certification
Jun 12, 2024
Beds
18
Ownership / control type
County
Organization structure
OtherNon-profit
Enrollment address
315 W 15TH St
Liberal, KS 67901-2455
Nursing home name
SOUTHWEST MEDICAL CENTER SNF

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Southwest Medical Center SNFCCN 175163 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Quality measures
3 of 5
Type
Medicare
Ownership
Government - County
Certified
Jul 31, 1987
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
182.8 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Southwest Kansas Pathol3 organizations share this tax ID, including this one
Part of
Southwest Kansas Pathol

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Keeley R Moree Individual W-2 Managing EmployeeVP Practice Management Jun 1, 2019
Ivanhoe Love Individual Corporate DirectorBoard of Trustees Mar 18, 2018
Maria Lauralynn Noblejas Individual Corporate DirectorBoard of Trustees Jul 1, 2021
Dennis L Knudsen Individual Corporate DirectorBoard of Trustees Apr 1, 2022
Sandra Cain Individual W-2 Managing EmployeeChief Nursing Officer May 1, 2021
Jose Lara Individual Corporate DirectorBoard of Trustees Apr 1, 2021
Mark Cowan Individual Corporate OfficerChief Operating Officer May 1, 2015
W-2 Managing EmployeeChief Operating Officer May 1, 2015
John West Individual Corporate Director Apr 1, 2022
Amber Williams Individual Corporate DirectorCfo / VP Finance Sep 28, 2014
W-2 Managing Employee Jul 1, 1997
Tony McKee Individual Corporate Director Apr 1, 2022
Dennis Sander Individual Corporate DirectorBoard of Trustees Apr 1, 2015

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418342400000",
    "number": "1407890692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W 15TH STREET",
            "address_2": "PO BOX 1340",
            "city": "LIBERAL",
            "state": "KS",
            "postal_code": "679051340",
            "telephone_number": "620-624-1651",
            "fax_number": "620-629-2472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W 15TH ST",
            "city": "LIBERAL",
            "state": "KS",
            "postal_code": "679012455",
            "telephone_number": "620-624-1651",
            "fax_number": "620-629-2472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHWEST MEDICAL CENTER",
        "enumeration_date": "2006-06-16",
        "last_updated": "2014-12-12",
        "status": "A",
        "authorized_official_last_name": "ERMANN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "620-629-6400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KS",
            "license": "175163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Skilled Nursing Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Liberal, KS

Sources for this page

Verify at the official NPI Registry.