NPIMap

Organization Active NPI

Bethesda Lutheran Communities

  • Intellectual Disabilities Intermediate Care Facility
  • Shawnee Mission, KS
National Provider Identifier
1669618864
Registry record updated Feb 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
BETHESDA LUTHERAN COMMUNITIES
Practice address
14150 W 113TH St
Shawnee Mission, KS 66215-4819
Phone
(913) 906-5000
Fax
(913) 469-4028
NPI assigned
Dec 18, 2008
Last updated
Feb 5, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2013

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

Authorized official

Name
Mr. Jeffrey A. Kaczmarski
Title
VP of Legal Affairs
Phone
(920) 206-4406

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X KS Primary

Addresses

Primary practice location

14150 W 113TH St
Shawnee Mission, KS 66215-4819

Mailing address

14235 W 113 St
Shawnee Mission, KS 66215
Phone (913) 906-5000

Other identifiers 1

IdentifierTypeStateIssuer
10010839DMedicaidKS

Other names 1

  • Faith Village III Other name

National Provider Directory

National Provider Directory
Tax ID family
Ablelight Inc29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1229558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360022400000",
    "number": "1669618864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14235 W 113 ST",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "66215",
            "telephone_number": "913-906-5000",
            "fax_number": "913-469-4028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14150 W 113TH ST",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "662154819",
            "telephone_number": "913-906-5000",
            "fax_number": "913-469-4028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHESDA LUTHERAN COMMUNITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-18",
        "last_updated": "2013-02-05",
        "status": "A",
        "authorized_official_last_name": "KACZMARSKI",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "VP OF LEGAL AFFAIRS",
        "authorized_official_telephone_number": "920-206-4406",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10010839D",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Faith Village III",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Shawnee Mission, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.