NPIMap

Organization Active NPI

Prime Healthcare Services - Saint John Leavenworth, LLC

  • Medicare Defined Swing Bed Hospital Unit
  • Leavenworth, KS
National Provider Identifier
1609219799
Registry record updated Jul 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
PRIME HEALTHCARE SERVICES - SAINT JOHN LEAVENWORTH, LLC
Practice address
3500 S 4TH St
Leavenworth, KS 66048-5043
Phone
(909) 235-4400
Fax
(909) 235-4418
NPI assigned
Apr 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2013

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 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) 235-4400

Other names 1

  • Saint John Leavenworth TCU Unit Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374710400000",
    "number": "1609219799",
    "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": "909-235-4400",
            "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": "909-235-4400",
            "fax_number": "909-235-4418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE SERVICES - SAINT JOHN LEAVENWORTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-09",
        "last_updated": "2013-07-25",
        "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."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saint John Leavenworth TCU Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leavenworth, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2013; 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.