NPIMap

Organization Active NPI

Streetcar Healthcare, Inc.

Doing business as Providence Place

  • Skilled Nursing Facility
  • Kansas City, KS
National Provider Identifier
1710667654
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
STREETCAR HEALTHCARE, INC.
Doing business as
Providence Place
Practice address
8909 Parallel Pkwy
Kansas City, KS 66112-1689
Phone
(913) 279-0472
NPI assigned
Jul 24, 2023
Last updated
Jun 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Authorized official

Name
Soon Burnam
Title
Authorized Official
Phone
(949) 540-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

8909 Parallel Pkwy
Kansas City, KS 66112-1689

Mailing address

8909 Parallel Pkwy
Kansas City, KS 66112-1689
Phone (913) 279-0472

Other names 1

  • Providence Place Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0NhinService/XDRReesponse_Service Other eSolutions Inc.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231109002793 KS Part A Provider - Skilled Nursing Facility 4789031915 Practice locations: Kansas City, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1710667654. Details of each certification follow.

Skilled nursing facility certification: CCN 175159

Legal name
STREETCAR HEALTHCARE, INC.
Doing business as
PROVIDENCE PLACE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 11, 1987
Last certification
Nov 1, 2023
Beds
45
Ownership / control type
Corporation
Multi-facility organization
Gateway Health Inc.
Organization structure
CorporationProprietary
Incorporated
Jun 27, 2023 in NV
Enrollment address
8909 Parallel Pkwy
Kansas City, KS 66112-1689
Nursing home name
PROVIDENCE PLACE
Affiliated entity
THE ENSIGN GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Providence PlaceCCN 175159 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Mar 11, 1987
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4543.4 residents per day on average
Chain
The Ensign Group342 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 7

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

NameRoleSinceShare
Corwin Lewis Individual Corporate OfficerPresident Oct 1, 2023
The Ensign Group Inc Organization, San Juan Capistrano, CA Corporation 5% Or Greater Indirect Ownership Interest Jun 27, 2023 100%
Gateway Healthcare LLC Organization, San Juan Capistrano, CA LLC 5% Or Greater Direct Ownership Interest Jun 27, 2023 100%
Spencer W Burton Individual Corporate DirectorDirector Oct 1, 2023
Craig Fitch Individual Corporate OfficerSecretary Oct 1, 2023
Michael Brooks Individual W-2 Managing EmployeeAdministrator Oct 1, 2023 100%
Operational/Managerial ControlPresident Oct 1, 2023 100%
Soon Burnam Individual Corporate OfficerTreasurer Oct 1, 2023

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 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1690156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749513600000",
    "number": "1710667654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8909 PARALLEL PKWY",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661121689",
            "telephone_number": "913-279-0472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8909 PARALLEL PKWY",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661121689",
            "telephone_number": "913-279-0472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STREETCAR HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-24",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0NhinService/XDRReesponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Providence Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.