NPIMap

Organization Active NPI

Medicalodges, Inc.

  • Skilled Nursing Facility
  • Great Bend, KS
National Provider Identifier
1669967436
Registry record updated Dec 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MEDICALODGES, INC.
Practice address
1401 Cherry LN
Great Bend, KS 67530-3152
Phone
(620) 792-2165
NPI assigned
Jun 25, 2018
Organization subpart
Yes
Parent organization
MEDICALODGES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 27, 2018

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

Authorized official

Name
Mr. Scott Hines
Title
Cfo
Phone
(620) 709-0305

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1401 Cherry LN
Great Bend, KS 67530-3152

Mailing address

PO Box 509
Coffeyville, KS 67337-0509
Phone (620) 251-6700

Other identifiers 1

IdentifierTypeStateIssuer
100107470AMedicaidKS

Other names 1

  • Medicalodges Great Bend Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181025001855 KS Part A Provider - Skilled Nursing Facility 4688585979 Practice locations: Great Bend, KS

Skilled nursing facility certification: CCN 175522

Legal name
MEDICALODGES INC
Doing business as
MEDICALODGES GREAT BEND
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 1, 2011
Last certification
Jul 24, 2024
Beds
62 (51 certified)
Ownership / control type
Corporation
Multi-facility organization
Medicalodges, Inc
Most recent change of ownership
Aug 1, 2018
Organization structure
CorporationProprietary
Incorporated
Apr 19, 1976 in KS
Enrollment address
1401 Cherry LN
Great Bend, KS 67530-3152
Nursing home name
MEDICALODGES GREAT BEND
Affiliated entity
MEDICALODGES, INC.

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

Care Compare: Nursing home

Medicare Care Compare
Listed as
Medicalodges Great BendCCN 175522
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Oct 1, 2011
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5143.5 residents per day on average
Chain
Medicalodges, Inc.18 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
4Fines totaling $52,185

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D0452733Medicalodges Great Bend1401 Cherry Lane, Great Bend, KS 67530Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Medicalodges Inc47 organizations share this tax ID, including this one
Part of
Medicalodges Inc

Other organizations with this tax ID 46

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

View all 46

Locations

511 N Western Ave
Girard, KS 66743
Phone (620) 724-8288

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Catherine W Rohling McCord Individual Corporate OfficerVice President of Financial Reporti Jun 9, 2000
Ron Ott Individual Corporate DirectorBoard Member Sep 15, 2006
Kathleen L Lantz Individual Corporate OfficerVP of Employee Engagement Nov 1, 2013
Travis I McBride Individual Corporate OfficerRegional Vice President Nov 1, 2013
Richard Butler Individual Corporate DirectorChairman of the Board Jul 1, 2003
Alisha Craft Individual W-2 Managing EmployeeAdministrator Oct 1, 2018
Pamela L Smith Individual Corporate OfficerVP of Compliance Jul 1, 2014
Staci Cardenas Individual Corporate OfficerRegional Vice President Jul 1, 2014
Carol Marshall Individual Corporate DirectorBoard Member Jul 27, 2006
Gayle M Doll Individual Corporate DirectorBoard Member Mar 10, 2005
Medicalodges Inc Organization, Coffeyville, KS Corporation 5% Or Greater Direct Ownership Interest Apr 19, 1976 100%
Other Aug 1, 2018 100%
Teresa Coover Individual Corporate OfficerVP of Clinical Services Sep 21, 2017
Garen L Cox Individual Corporate OfficerChief Executive Officer Dec 18, 2009
Corporate DirectorPresident Feb 26, 1998
Scott L Hines Individual Corporate OfficerChief Financial Officer Mar 20, 2009
Corporate DirectorVice President Sep 19, 2009
Shannon M Lager Individual Corporate OfficerChief Operations Officer Jun 1, 2013
Corporate DirectorVice President Mar 23, 2018

Owners & managing parties with NPI records 15

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 15

All facility ownership & control disclosures 18

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Medicalodges WichitaWichita, KS, CCN 175008 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Apr 19, 1976
Apr 19, 1976
Jul 15, 2025
Medicalodges DeweyDewey, OK, CCN 375150 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 19, 1976
Medicalodges Fort ScottFort Scott, KS, CCN 175258 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 19, 1976
Medicalodges Arkansas CityArkansas City, KS, CCN 175313 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 10, 2015
PharmericaColumbus, KS, CCN 175264 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Oct 28, 2014
Medicalodges NeoshoNeosho, MO, CCN 265266 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 19, 1976
Medicalodges ButlerButler, MO, CCN 265564 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Medicalodges KinsleyKinsley, KS, CCN 175275 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 4, 1966
Medicalodges NevadaNevada, MO, CCN 265493 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Medicalodges AtchinsonAtchison, KS, CCN 175141 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 1966
Cascade Health ServicesLeavenworth, KS, CCN 175162 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Apr 19, 1976
Apr 19, 1976
Jul 16, 2025
Medicalodges PaolaPaola, KS, CCN 175413 Skilled nursing facility 5% Or Greater Direct Ownership Interest Jul 22, 2009
Medicalodges EudoraEudora, KS, CCN 175502 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2007
Medicalodges FrontenacFontenac, KS, CCN 175363 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Mar 1, 2013
Mar 1, 2013
Dec 17, 2025
Medicalodges IndependenceIndependence, KS, CCN 175464 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Other (100%)		 Apr 19, 1976
Nov 1, 2013
Medicalodges Coffeyville on MidlandCoffeyville, KS, CCN 175290 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2022
Medicalodges IolaIola, KS, CCN 175226 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2022
Medicalodges GoddardGoddard, KS, CCN 175294 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 1, 2025
Nov 14, 2025

Owned or controlled facilities with NPI records 18

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 18

Facilities with the same owner 18

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 18

Practitioners & affiliated clinicians

Practitioners 2

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

Affiliated clinicians 8

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545868800000",
    "number": "1669967436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 509",
            "city": "COFFEYVILLE",
            "state": "KS",
            "postal_code": "673370509",
            "telephone_number": "620-251-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 CHERRY LN",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303152",
            "telephone_number": "620-792-2165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICALODGES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDICALODGES, INC.",
        "enumeration_date": "2018-06-25",
        "last_updated": "2018-12-27",
        "status": "A",
        "authorized_official_last_name": "HINES",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "620-709-0305",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100107470A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicalodges Great Bend",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medicalodges Great Bend",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Great Bend, KS

Sources for this page

Verify at the official NPI Registry.