NPIMap

Organization Active NPI

Prime Healthcare Services - Saint John Leavenworth, LLC

Doing business as Saint John Hospital

  • General Acute Care Hospital
  • Leavenworth, KS
National Provider Identifier
1568705267
Registry record updated Jul 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
PRIME HEALTHCARE SERVICES - SAINT JOHN LEAVENWORTH, LLC
Doing business as
Saint John Hospital
Practice address
3500 S 4TH St
Leavenworth, KS 66048-5043
Phone
(909) 235-4362
Fax
(909) 235-4418
NPI assigned
Apr 1, 2013
Last updated
Jul 1, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2013

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

Authorized official

Name
Mr. Luis Leon, MD
Title
President of Operations II
Phone
(909) 235-4362

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X KS Primary

Addresses

Primary practice location

3500 S 4TH St
Leavenworth, KS 66048-5043

Mailing address

3500 S 4TH St
Leavenworth, KS 66048-5043
Phone (909) 235-4362

Other names 1

  • Saint John Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130328000056 KS Part A Provider - Hospital 9133364961 Practice locations: Leavenworth, KS; Lansing, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1568705267. Details of each certification follow.

Hospital certification: CCN 170009

Legal name
PRIME HEALTHCARE SERVICES - SAINT JOHN LEAVENWORTH LLC
Doing business as
SAINT JOHN HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jan 31, 2008
Beds
76
Ownership / control type
Other
Most recent change of ownership
Apr 1, 2013 (1 total)
Organization structure
LLCProprietary
Enrollment address
3500 S 4TH St
Leavenworth, KS 66048-5043
Other Hospital Practice Location
Hospital subgroups
Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Saint John HospitalCCN 170009 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Prime Healthcare Services - Saint John Leavenworth LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Prime Healthcare Services, Inc Organization, Ontario, CA For-profit 5% Or Greater Direct Ownership Interest Jan 31, 2013 100%
Operational/Managerial Control Apr 1, 2013 100%
Luis Leon Individual Corporate OfficerRegional Chief Executive Officer Sep 1, 2023
Corporate DirectorDirector Sep 1, 2023
W-2 Managing EmployeeRegional Chief Executive Officer Sep 1, 2023
Steven Aleman Individual OtherChief Financial Officer Jun 1, 2020
Christopher Doan Individual Corporate OfficerChief Compliance Cousel Sep 1, 2017

Facilities with the same owner 75

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 75

Practitioners & affiliated clinicians

Practitioners 7

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.

Affiliated clinicians 129

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 129

NPI Registry JSON

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

{
    "created_epoch": "1364774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372636800000",
    "number": "1568705267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 S 4TH ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660485043",
            "telephone_number": "909-235-4362",
            "fax_number": "909-235-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 S 4TH ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660485043",
            "telephone_number": "909-235-4362",
            "fax_number": "909-235-4418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE SERVICES - SAINT JOHN LEAVENWORTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-01",
        "last_updated": "2013-07-01",
        "status": "A",
        "authorized_official_last_name": "LEON",
        "authorized_official_first_name": "LUIS",
        "authorized_official_title_or_position": "PRESIDENT OF OPERATIONS II",
        "authorized_official_telephone_number": "909-235-4362",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saint John Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leavenworth, KS

Sources for this page

Verify at the official NPI Registry.