NPIMap

Organization Active NPI

Judge James V Riddel Boys Ranch

  • Psychiatric Residential Treatment Facility
  • Goddard, KS
National Provider Identifier
1639225667
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
0003181-001 Issued in KS
Legal business name
JUDGE JAMES V RIDDEL BOYS RANCH
Practice address
25331 W 39TH St S
Goddard, KS 67052-9244
Phone
(316) 660-1600
Fax
(316) 794-2061
NPI assigned
Jan 25, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mark Masterson
Title
Director of Corrections
Phone
(316) 660-9750

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X 0003181-001 KS Primary

Addresses

Primary practice location

25331 W 39TH St S
Goddard, KS 67052-9244

Mailing address

700 S Hydraulic St
Wichita, KS 67211-2704

National Provider Directory

National Provider Directory
Tax ID family
Sedg Co Dept of M H12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

700 S Hydraulic St
Wichita, KS 67211

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639225667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S HYDRAULIC ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672112704",
            "fax_number": "316-660-1670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25331 W 39TH ST S",
            "city": "GODDARD",
            "state": "KS",
            "postal_code": "670529244",
            "telephone_number": "316-660-1600",
            "fax_number": "316-794-2061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDGE JAMES V RIDDEL BOYS RANCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MASTERSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DIRECTOR OF CORRECTIONS",
        "authorized_official_telephone_number": "316-660-9750"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "KS",
            "license": "0003181-001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goddard, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.