Thi of Kansas at Indian Creek, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

THI OF KANSAS AT INDIAN CREEK, LLC

Doing business as

Indian Creek Healthcare Center

Practice address

6515 W 103Rd St
Overland Park, KS 66212-1728

Phone

(913) 642-5545

Fax

(913) 642-3982

NPI assigned

Oct 7, 2006

Organization subpart

No

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

Authorized official

Name

Glenna Caldwell

Title

President

Phone

(913) 642-5545

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Indian Creek Healthcare Center Doing business as

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

{
    "created_epoch": "1160179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308614400000",
    "number": "1407943699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 RIDGEBROOK RD",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "211529390",
            "telephone_number": "410-773-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6515 W 103RD ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662121728",
            "telephone_number": "913-642-5545",
            "fax_number": "913-642-3982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THI OF KANSAS AT INDIAN CREEK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-07",
        "last_updated": "2011-06-21",
        "status": "A",
        "authorized_official_last_name": "CALDWELL",
        "authorized_official_first_name": "GLENNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "913-642-5545"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1042125101",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Indian Creek Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Overland Park, KS
• Providers in Overland Park, 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 Jun 21, 2011; 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.