Mid-America at Peabody, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

100107310A Issued in KS

Legal business name

MID-AMERICA AT PEABODY, LLC

Practice address

407 N Locust St
Peabody, KS 66866-1117

Phone

(620) 983-2152

Fax

(620) 983-2281

NPI assigned

Oct 4, 2005

Last updated

Mar 30, 2011By 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

Victoria Nichols, ADMINISTRATOR

Title

Administrator

Phone

(620) 983-2152

Specialties & licenses 3

Addresses

Other identifiers 2

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301443200000",
    "number": "1518954569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 N LOCUST ST",
            "city": "PEABODY",
            "state": "KS",
            "postal_code": "668661117",
            "telephone_number": "620-983-2152",
            "fax_number": "620-983-2281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 N LOCUST ST",
            "city": "PEABODY",
            "state": "KS",
            "postal_code": "668661117",
            "telephone_number": "620-983-2152",
            "fax_number": "620-983-2281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-AMERICA AT PEABODY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2011-03-30",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "620-983-2152",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "KS",
            "license": "100419260A",
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "KS",
            "license": "100419260A",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KS",
            "license": "100107310A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100107310A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100419260A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heritage Medical Associates, P.a.
• Gretchen Hind
• Markleysburg Healthcare Investors (Westview Manor of Peabody)
• Sarah McLeod, LMSW
• Medical Center Pharmacy Inc (Dons Rexall Drug)
• Murphy Wellness LLC
• Jennifer E Murphy, CRNP
• Native Roots Health & Wellness
• Peabody Dentistry LLC
• Peabody Operator, LLC (Peabody Health and Rehab)

• Skilled Nursing Facility in Peabody, KS
• Providers in Peabody, 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 Mar 30, 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.