NPIMap

Organization Active NPI

Cornerstone Assisted Living

  • Assisted Living Facility
  • Wichita, KS
National Provider Identifier
1720118342
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
N087041 Issued in KS
Legal business name
CORNERSTONE ASSISTED LIVING
Practice address
1240 N Broadmoor Ave
Wichita, KS 67206-3896
Phone
(316) 636-5101
Fax
(316) 636-2576
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
William J Slater
Title
Vice President of Finance
Phone
(316) 946-5215

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X N087041 KS Primary

Addresses

Primary practice location

1240 N Broadmoor Ave
Wichita, KS 67206-3896

Mailing address

1240 N Broadmoor Ave
Wichita, KS 67206-3896
Phone (316) 636-5101

Other identifiers 1

IdentifierTypeStateIssuer
200104501083MedicaidKS

Other names 1

  • Cornerstone Broadmoor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cornerstone Assisted Living4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720118342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 N BROADMOOR AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063896",
            "telephone_number": "316-636-5101",
            "fax_number": "316-636-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 N BROADMOOR AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063896",
            "telephone_number": "316-636-5101",
            "fax_number": "316-636-2576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SLATER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "316-946-5215"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "KS",
            "license": "N087041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200104501083",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornerstone Broadmoor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.