Prime Healthcare Services-Providence, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

N105013 Issued in KS

Legal business name

PRIME HEALTHCARE SERVICES-PROVIDENCE, LLC

Practice address

8929 Parallel Pkwy
Kansas City, KS 66112-1689

Phone

(913) 596-3229

NPI assigned

Aug 23, 2016

Organization subpart

No

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

Authorized official

Name

Christopher Doan

Title

Chief Compliance Counsel

Phone

(909) 235-4307

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Providence Medical Center Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Prime Healthcare Services-Providence, LLC

  • General Acute Care Hospital
  • Kansas City, KS
  • NPI 1528301900

  Member Of

  NPD member

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

{
    "created_epoch": "1471910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471910400000",
    "number": "1639624364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8929 PARALLEL PKWY",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661121689",
            "telephone_number": "913-596-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8929 PARALLEL PKWY",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661121689",
            "telephone_number": "913-596-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE SERVICES-PROVIDENCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-23",
        "last_updated": "2016-08-23",
        "status": "A",
        "authorized_official_last_name": "DOAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE COUNSEL",
        "authorized_official_telephone_number": "909-235-4307"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KS",
            "license": "N105013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOSPITAL LICENSE",
            "identifier": "H-105-003",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nathan Robert Prichard, D.O.
• Gregory Alan Prier, DO
• Jorge Nelson Prieto, M.D.
• Prime Emergency Physicians, LLC
• Prime Healthcare Services-Providence, LLC
• Kenneth Ray Pringle, DPT, ATC
• Michael Pritchett, MD
• Procare Pharmacy, L.L.C.
• Katherine Louise Proch, MD
• Jennifer S Proctor, PA-C

• Skilled Nursing Facility in Kansas City, KS
• Providers in Kansas City, 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 Aug 23, 2016; 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.