Vintage Park at Tonganoxie, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

N052008 Issued in KS

Legal business name

VINTAGE PARK AT TONGANOXIE, LLC

Practice address

120 W. 8TH Street
Tonganoxie, KS 66086

Phone

(913) 845-2204

Fax

(913) 845-2358

NPI assigned

May 22, 2009

Last updated

May 22, 2009By 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

Mr. Matt Moore

Title

President

Phone

(949) 282-5800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1242950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242950400000",
    "number": "1578798385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W. 8TH STREET",
            "city": "TONGANOXIE",
            "state": "KS",
            "postal_code": "66086",
            "telephone_number": "913-845-2204",
            "fax_number": "913-845-2358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W. 8TH STREET",
            "city": "TONGANOXIE",
            "state": "KS",
            "postal_code": "66086",
            "telephone_number": "913-845-2204",
            "fax_number": "913-845-2358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINTAGE PARK AT TONGANOXIE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-22",
        "last_updated": "2009-05-22",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-282-5800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "KS",
            "license": "N052008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tonganoxie Nursing and Rehab LLC
• Tonganoxie Opco LLC
• Wendy Trout
• Katherine Turner
• Unified School District No. 464
• Katelyn Marie Volk, O.D.
• William B Weatherford, MD
• Nicole Wence
• Keith Wentz
• Ryan David West, DPT

• Assisted Living Facility in Tonganoxie, KS
• Providers in Tonganoxie, 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 May 22, 2009; 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.