NPIMap

Organization Active NPI

Garden Valley Retirement Village, LLC

  • Skilled Nursing Facility
  • Garden City, KS
National Provider Identifier
1710210943
Registry record updated May 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
GARDEN VALLEY RETIREMENT VILLAGE, LLC
Practice address
1505 East Spruce Street
Garden City, KS 67846
Phone
(620) 275-9651
Fax
(620) 275-6582
NPI assigned
Sep 4, 2009
Last updated
May 26, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2015

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

Authorized official

Name
Dean Kiklis
Title
Cfo
Phone
(303) 952-9216

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1505 East Spruce Street
Garden City, KS 67846

Mailing address

1505 East Spruce Street
Garden City, KS 67846
Phone (620) 275-9651

Other identifiers 1

IdentifierTypeStateIssuer
1041134501MedicaidKS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100329000191 KS Part A Provider - Skilled Nursing Facility 2264568369 Practice locations: Garden City, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1710210943. Details of each certification follow.

Skilled nursing facility certification: CCN 175175

Legal name
GARDEN VALLEY RETIREMENT VILLAGE, LLC
Doing business as
GARDEN VALLEY RETIREMENT VILLAGE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 6, 1988
Last certification
Jun 29, 2023
Beds
63 (62 certified)
Ownership / control type
Corporation
Multi-facility organization
Fontline Management
Organization structure
LLCProprietary
Enrollment address
1505 E Spruce St
Garden City, KS 67846-6250
Nursing home name
GARDEN VALLEY RETIREMENT VILLAGE
Affiliated entity
FRONTLINE MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Garden Valley Retirement VillageCCN 175175 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Sep 6, 1988
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6250.9 residents per day on average
Chain
Frontline Management9 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 30

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

NameRoleSinceShare
Kristain Pittillo Individual Operational/Managerial Control Nov 1, 2020
Adp of the SNF Nov 1, 2020
Bokf,NA Organization, Tulsa, OK Financial institution Adp of the SNF Jun 13, 2019
Robert Jones Individual Operational/Managerial Control May 10, 2012
Adp of the SNF May 10, 2012
Roberto Perez Individual Operational/Managerial Control Sep 24, 2022
Adp of the SNF Sep 24, 2022
Frontier Management Inc Organization, Lafayette, CO Corporation, Chain home office Operational/Managerial Control Jul 19, 2009 100%
Adp of the SNF Nov 4, 2025
Heather Orback Individual Operational/Managerial Control Sep 20, 2011
Adp of the SNF Sep 20, 2011
Frontline MDS Exchange LLC Organization, Lafayette, CO Consulting firm Adp of the SNF Mar 1, 2025
Gregory Allen Falk Individual 5% Or Greater Direct Ownership Interest Jul 19, 2009 50%
Michelle Newton Individual Operational/Managerial Control Jun 2, 2014
Adp of the SNF Jun 2, 2014
Openwork Health LLC Organization, Great Bend, KS Medical staffing company Adp of the SNF Mar 31, 2022
Scott D Booker Individual Operational/Managerial Control Jul 1, 2022
Adp of the SNF Jul 1, 2022
Finanical Management Inc Organization, Cimarron, KS Corporation Adp of the SNF Jan 1, 2010
Renae Kersenbrock Individual Operational/Managerial Control Sep 2, 2025
Adp of the SNF Sep 2, 2025
Pinnacle Pharmacy Group Inc Organization, Cimarron, KS Corporation Adp of the SNF Mar 1, 2025
Jennifer Johnston Individual Operational/Managerial Control Dec 19, 2023
Adp of the SNF Dec 19, 2023
Paul Veluscek Individual 5% Or Greater Direct Ownership Interest Jul 19, 2009 5%
Adam Baker Individual Operational/Managerial Control Apr 16, 2020
Adp of the SNF Apr 16, 2020
Elliot Lekawa Individual Adp of the SNF Nov 1, 2019
Edison Ong Individual Corporate OfficerChief Financial Officer Apr 4, 2025
Operational/Managerial Control Apr 4, 2025
Adp of the SNF Apr 4, 2025
Tamara Altman Individual Operational/Managerial Control May 1, 2025
Adp of the SNF May 1, 2025
Vicki Holland Individual Operational/Managerial Control Nov 25, 2020
Direct Ownership Interest Nov 25, 2020
Angela Scott Individual Operational/Managerial Control Apr 1, 2020
Adp of the SNF Apr 1, 2020
Morghan Allen Individual Operational/Managerial Control Jun 1, 2025
Adp of the SNF Jun 1, 2025
Karen Lozano Individual Operational/Managerial Control Mar 4, 2024
Adp of the SNF Mar 4, 2024
Cherise Salas Individual Operational/Managerial Control Jun 2, 2014
Adp of the SNF Jun 2, 2014
Steven W Veluscek Individual 5% Or Greater Direct Ownership Interest Jul 19, 2009 45%
Integra Accounting Solutions LLC Organization, Wichita, KS LLC Adp of the SNF Jan 1, 2025
Jill Stevenson Individual Operational/Managerial Control May 28, 2025
Adp of the SNF May 28, 2025
Carmen Calzada Individual Operational/Managerial Control Mar 18, 2022
Adp of the SNF Mar 18, 2022
Key Rehabilitation Inc Organization, Murfreesboro, TN Corporation Adp of the SNF Feb 1, 2024

Owners & managing parties with NPI records 11

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

Facilities with the same owner 8

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

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 4

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": "1252022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432598400000",
    "number": "1710210943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 EAST SPRUCE STREET",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "67846",
            "telephone_number": "620-275-9651",
            "fax_number": "620-275-6582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 EAST SPRUCE STREET",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "67846",
            "telephone_number": "620-275-9651",
            "fax_number": "620-275-6582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN VALLEY RETIREMENT VILLAGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-04",
        "last_updated": "2015-05-26",
        "status": "A",
        "authorized_official_last_name": "KIKLIS",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "303-952-9216"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1041134501",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, KS

Sources for this page

Verify at the official NPI Registry.