Active NPI
Pioneer Ridge Nursing Facility Operations, LLC
Doing business as Pioneer Ridge Retirement Community
- Skilled Nursing Facility
- Lawrence, KS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 175445
- Legal business name
- PIONEER RIDGE NURSING FACILITY OPERATIONS, LLC
- Doing business as
- Pioneer Ridge Retirement Community
- Practice address
- 4851 Harvard Road
Lawrence, KS 66049 - Phone
- (785) 749-2000
- Fax
- (785) 344-1199
- NPI assigned
- Dec 11, 2006
- Last updated
- Jul 18, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Mike D Tryon
- Title
- Cfo
- Phone
- (785) 272-1535
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | 100112080A | KS | |
| Skilled Nursing Facility | 314000000X | 175445 | KS | Primary |
Addresses
Primary practice location
4851 Harvard Road
Lawrence, KS 66049
Mailing address
3024 SW Wanamaker Rd Ste 300
Topeka, KS 66614-4498
Phone (785) 228-7913
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100112080A | Medicaid | KS |
Other names 1
- Pioneer Ridge Retirement Community
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031008000031 | KS | Part A Provider - Skilled Nursing Facility | 0244142123 | Practice locations: Lawrence, KS |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1467512137. Details of each certification follow.
Skilled nursing facility certification: CCN 175445
- Legal name
- PIONEER RIDGE NURSING FACILITY OPERATIONS, LLC
- Doing business as
- PIONEER RIDGE RETIREMENT COMMUNITY
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 12, 2001
- Last certification
- Oct 17, 2024
- Beds
- 146 (76 certified)
- Ownership / control type
- Partnership
- Multi-facility organization
- Midwest Health Management
- Organization structure
- LLC
- Enrollment address
- 4851 Harvard Rd
Lawrence, KS 66049-3964 - Nursing home name
- PIONEER RIDGE RETIREMENT COMMUNITY
- Affiliated entity
- MIDWEST HEALTH
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Pioneer Ridge Retirement Community
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Partnership
- Certified
- Jul 12, 2001
- Medicare certification status
- Active
- Certified beds
- 76
- Chain
- Midwest Health
- Penalties (3 years)
- 2
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 17D0986841 | Pioneer Ridge Retirement Community | Certificate of waiver | May 22, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Midwest Health Services
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Skilled Nursing Facility
- Lawrence, KS
- NPI 1457756918
Ownership & related parties
All disclosed owners & managing parties 9
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Floyd Charles Eaton | 5% Or Greater Direct Ownership Interest | Jun 26, 2003 | 50% |
| Corporate Director | Oct 21, 2003 | ||
| James Brett Klausman Trust 2012 | 5% Or Greater Indirect Ownership Interest | Jul 1, 2016 | 24.75% |
| Adp of the SNF | Dec 27, 2024 | ||
| James a Klausman | 5% Or Greater Indirect Ownership Interest | Jun 26, 2003 | 0.5% |
| Corporate Director | Jun 26, 2003 | 50% | |
| Operational/Managerial Control | Nov 7, 2024 | ||
| Indirect Ownership Interest | Jun 26, 2003 | 0.5% | |
| Floyd C Eaton III Trust 2012 | 5% Or Greater Indirect Ownership Interest | Jul 1, 2016 | 24.75% |
| Adp of the SNF | Dec 27, 2024 | ||
| Midwest Health, Inc. 06122001 | Operational/Managerial Control | Jan 1, 2010 | |
| Adp of the SNF | Dec 27, 2024 | ||
| Floyd Eaton | 5% Or Greater Indirect Ownership Interest | Jun 26, 2003 | 0.5% |
| Operational/Managerial Control | Nov 7, 2024 | ||
| Indirect Ownership Interest | Jun 26, 2003 | 0.5% | |
| Jamie N Eaton Trust 2012 | 5% Or Greater Indirect Ownership Interest | Jul 1, 2016 | 24.75% |
| Adp of the SNF | Dec 27, 2024 | ||
| Michael Graham Klausman Trust 2012 | 5% Or Greater Indirect Ownership Interest | Jul 1, 2016 | 24.75% |
| Adp of the SNF | Dec 27, 2024 | ||
| Klaton Enterprises, LLC | 5% Or Greater Direct Ownership Interest | Jun 26, 2003 | 100% |
| Adp of the SNF | Dec 27, 2024 |
Facilities with the same owner 10
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Halstead Health and Rehabilitation
- Skilled Nursing Facility
- Halstead, KS
- NPI 1508926312
Floyd C Eaton III Trust 2012, James Brett Klausman Trust 2012, Jamie N Eaton Trust 2012, Michael Graham Klausman Trust 2012, Midwest Health, Inc. 06122001
-
dba Holiday Resort of Salina
- Skilled Nursing Facility
- Salina, KS
- NPI 1801956610
Floyd C Eaton III Trust 2012, James Brett Klausman Trust 2012, Jamie N Eaton Trust 2012, Michael Graham Klausman Trust 2012, Midwest Health, Inc. 06122001
-
dba Lexington Park Nursing and Post Acute Center
- Skilled Nursing Facility
- Topeka, KS
- NPI 1962562785
Floyd C Eaton III Trust 2012, James Brett Klausman Trust 2012, Jamie N Eaton Trust 2012, Klaton Enterprises, LLC, Michael Graham Klausman Trust 2012, Midwest Health, Inc. 06122001
-
- Skilled Nursing Facility
- Garden City, KS
- NPI 1700383759
Floyd C Eaton III Trust 2012, James Brett Klausman Trust 2012, Jamie N Eaton Trust 2012, Klaton Enterprises, LLC, Michael Graham Klausman Trust 2012, Midwest Health, Inc. 06122001
-
dba Rolling Hills Health Center
- Skilled Nursing Facility
- Topeka, KS
- NPI 1134289804
Floyd C Eaton III Trust 2012, James Brett Klausman Trust 2012, Jamie N Eaton Trust 2012, Klaton Enterprises, LLC, Michael Graham Klausman Trust 2012, Midwest Health, Inc. 06122001
-
dba Stoneybrook Retirement Community
- Skilled Nursing Facility
- Manhattan, KS
- NPI 1912067695
Floyd C Eaton III Trust 2012, James Brett Klausman Trust 2012, Jamie N Eaton Trust 2012, Michael Graham Klausman Trust 2012, Midwest Health, Inc. 06122001
-
dba Twin Oaks Health and Rehab
- Skilled Nursing Facility
- Lansing, KS
- NPI 1134472640
Floyd C Eaton III Trust 2012, James Brett Klausman Trust 2012, Jamie N Eaton Trust 2012, Michael Graham Klausman Trust 2012, Midwest Health, Inc. 06122001
-
- Nursing Facility/Intermediate Care Facility
- Valley Falls, KS
- NPI 1740340439
Floyd C Eaton III Trust 2012, James Brett Klausman Trust 2012, Jamie N Eaton Trust 2012, Klaton Enterprises, LLC, Michael Graham Klausman Trust 2012, Midwest Health, Inc. 06122001
-
- Skilled Nursing Facility
- Ulysses, KS
- NPI 1205358959
Floyd C Eaton III Trust 2012, James Brett Klausman Trust 2012, Jamie N Eaton Trust 2012, Michael Graham Klausman Trust 2012, Midwest Health, Inc. 06122001
-
dba Arrowhead Retirement Community
- Skilled Nursing Facility
- Osage Beach, MO
- NPI 1982172342
Floyd C Eaton III Trust 2012, James Brett Klausman Trust 2012, Jamie N Eaton Trust 2012, Klaton Enterprises, LLC, Michael Graham Klausman Trust 2012, Midwest Health, Inc. 06122001
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.
-
- Internal Medicine Physician
- Lawrence, KS
- NPI 1225133812
Affiliated clinicians 3
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": "1165795200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1531872000000",
"number": "1467512137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3024 SW WANAMAKER RD STE 300",
"city": "TOPEKA",
"state": "KS",
"postal_code": "666144498",
"telephone_number": "785-228-7913",
"fax_number": "785-438-5513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4851 HARVARD ROAD",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "66049",
"telephone_number": "785-749-2000",
"fax_number": "785-344-1199"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PIONEER RIDGE NURSING FACILITY OPERATIONS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-11",
"last_updated": "2018-07-18",
"status": "A",
"authorized_official_last_name": "TRYON",
"authorized_official_first_name": "MIKE",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "785-272-1535",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "KS",
"license": "100112080A",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "KS",
"license": "175445",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100112080A",
"state": "KS"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Pioneer Ridge Retirement Community",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Pioneer Ridge Retirement Community",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Lawrence, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.