Shank Home LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

B047001 Issued in KS

Legal business name

SHANK HOME LLC

Practice address

111 W Railroad Ave
PO Box a
Lakin, KS 67860-6040

Phone

(620) 355-6803

Fax

(620) 355-6215

NPI assigned

Jan 30, 2013

Last updated

Jan 30, 2013By 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

Julia A Tubbs

Title

Owner/Operator

Phone

(620) 353-5351

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1359504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359504000000",
    "number": "1427396118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W RAILROAD AVE",
            "address_2": "PO BOX A",
            "city": "LAKIN",
            "state": "KS",
            "postal_code": "678606040",
            "telephone_number": "620-355-6803",
            "fax_number": "620-355-6215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W RAILROAD AVE",
            "address_2": "PO BOX A",
            "city": "LAKIN",
            "state": "KS",
            "postal_code": "678606040",
            "telephone_number": "620-355-6803",
            "fax_number": "620-355-6215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANK HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-30",
        "last_updated": "2013-01-30",
        "status": "A",
        "authorized_official_last_name": "TUBBS",
        "authorized_official_first_name": "JULIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "620-353-5351"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "KS",
            "license": "B047001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200677620A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhandi Lee Rexroat, FNP
• Tyler Ray Riedl, D.C.
• Ginnie Lynn Rincones, APRN
• Cristina Saavedra, LMSW
• Hannah Joann Schauf, PA-C
• Payden Mae Shapland, PA-C
• Spencer Allen Shirk
• Southwest Chiropractic and Wellness, PA
• Danica Steinle
• Luz Tucker, REGISTERED NURSE

• Adult Care Home Facility in Lakin, KS
• Providers in Lakin, KS by specialty
• Adult Care Home Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; 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.