CPF Senior Living - Fredonia LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CPF SENIOR LIVING - FREDONIA LLC

Doing business as

Vintage Park at Fredonia

Practice address

2111 E Washington St
Fredonia, KS 66736-1757

Phone

(620) 378-2329

NPI assigned

Dec 28, 2015

Last updated

Dec 28, 2015By 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

Jay Flatt

Title

Cfo

Phone

(312) 273-4750

Specialties & licenses 1

Addresses

Other names 1

• Vintage Park at Fredonia Doing business as

Locations

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

{
    "created_epoch": "1451260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451260800000",
    "number": "1447615083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 N MICHIGAN AVE",
            "address_2": "SUITE 1998",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 E WASHINGTON ST",
            "city": "FREDONIA",
            "state": "KS",
            "postal_code": "667361757",
            "telephone_number": "620-378-2329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CPF SENIOR LIVING - FREDONIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-28",
        "last_updated": "2015-12-28",
        "status": "A",
        "authorized_official_last_name": "FLATT",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "312-273-4750"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vintage Park at Fredonia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Oswaldo Cruz Bacani Sr., M.D.
• Koralyn Dawn Barkman, APRN-C
• James E Clay, DO
• Ronald Guy Cleverley, D.D.S., P.A.
• County of Wilson (Wilson County Health Department)
• DRS. Morris & Hill Medical Clinic, LLC
• Jacob Dugan, PHARM D.
• Holly Dyrud, LMSW
• Jessica L Evans, NP
• Fredonia Pharmacy Inc (Fredonia Pharmacy LTC)

• Assisted Living Facility in Fredonia, KS
• Providers in Fredonia, KS by specialty
• Assisted Living Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; 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.