Shawnee Mission Medical Center Inc
Organization Active NPI Psychiatric Hospital Unit · Merriam, KS
NPI 1720142565 · NPPES record last updated Dec 17, 2025
Key facts
- NPI
- 1720142565
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric Hospital Unit 273R00000X
- License
- H046004 (KS)
- Legal business name
- SHAWNEE MISSION MEDICAL CENTER INC
- Practice address
- 9100 W 74TH St
Merriam, KS 66204-4004 - Phone
- (913) 676-2000
- Fax
- (913) 676-7571
- NPI assigned
- Dec 19, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- SHAWNEE MISSION MEDICAL CENTER
Authorized official
- Name
- Stephanie Rosentreter
- Title
- Cfo
- Phone
- (620) 249-2457
Owners & managing parties with NPI records 3
-
Abigail Rose Proffer, M.D.
-
Reagan M Wittek, M.D.
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 13
Member organizations 6
Related certifications (CCN) 2
Facilities with the same owner 88
Practitioners 15
-
Henry F Arst, MD
-
Sylvia Michelle Gillis, APRN, FNP-C
-
Hailey Ann Lamaestra, PA-C
-
Carol Jane Sabath, APRN
-
Kerry A Sander, NURSE PRACTITIONER
-
Eloisa R Sarol, ARNP
-
Denette Vonada-Smith, NP-C
-
Maria Antoinette Whitcomb, APRN, FNP
-
Jamie R Ashcraft, APRN, FNP-C
-
Carter Grant Guyer, PA-C
-
Timothy W Hendrix, M.D.
-
Paula Ritter, FNP
-
Piyushkumar Jani, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Hospital certification: CCN 17S104
- Legal name
- SHAWNEE MISSION MEDICAL CENTER INC
- Doing business as
- ADVENTHEALTH SHAWNEE MISSION IP PSYCH
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 9100 W 74TH St
Merriam, KS 66204-4004 - Hospital subgroups
- Psychiatric
All disclosed owners & managing parties 28
| Name | Role | Since | Share |
|---|---|---|---|
| Gary Thurber |
Corporate Director |
Sep 17, 2015 | |
| David Vandevere |
Corporate Director |
Dec 12, 2023 | |
| Gregory Maddux |
Corporate Director |
Jan 1, 2006 | |
| Samuel Caughron |
Corporate Director |
Dec 12, 2023 | |
| Timothy R. Rodgers |
Corporate Officer |
May 25, 2021 | |
| Corporate Director |
Jan 1, 2020 | ||
| Reagan M Wittek |
Corporate Director |
Dec 12, 2019 | |
| Karsten Randolph |
Contracted Managing Employee |
Apr 1, 2014 | |
| Corporate Officer |
Apr 1, 2014 | ||
| Corporate Director |
Apr 1, 2014 | ||
| Barbara Cusick |
Corporate Director |
Feb 24, 2011 | |
| Adventisit Health Mid-America Inc |
5% Or Greater Direct Ownership Interest | Nov 1, 2011 | 100% |
| Andrew D Jahn |
Corporate Director |
Apr 1, 2024 | |
| Abigail R Proffer |
Corporate Director |
Dec 12, 2023 | |
| Twyla Rist |
Corporate Director |
Dec 12, 2023 | |
| Sam Huenergardt |
Corporate Director |
Jun 7, 2018 | |
| Michael Saunders |
Corporate Officer |
Feb 22, 2007 | |
| Paul C Rathbun |
Corporate Officer |
Sep 11, 2014 | |
| Stephen Williams |
Corporate Director |
Dec 12, 2023 | |
| Adventist Health System Sunbelt Healthcare Corporation |
5% Or Greater Indirect Ownership Interest | Nov 1, 2002 | 100% |
| Lyle Pishny |
Corporate Director |
Jan 29, 2008 | |
| Ronald Carlson |
Corporate Director |
Jan 1, 2006 | |
| Amanda Brady |
5% Or Greater Indirect Ownership Interest | Nov 1, 2002 | 100% |
| Alan David Verrill |
Contracted Managing Employee |
Feb 25, 2024 | |
| Corporate Officer |
Feb 12, 2023 | ||
| Corporate Director |
Feb 25, 2024 | ||
| Operational/Managerial Control |
Feb 25, 2024 | ||
| Toni Berrios |
Corporate Officer |
Jun 1, 2024 | |
| Stephanie Rosentreter |
Contracted Managing Employee |
Oct 5, 2025 | |
| Corporate Officer |
Oct 5, 2025 | ||
| Operational/Managerial Control |
Oct 5, 2025 | ||
| David L Huffman |
Corporate Officer |
Dec 12, 2019 | |
| Roger Bernard |
Corporate Director |
Jun 9, 2016 | |
| Lynn Addiscott |
Corporate Officer |
Jan 26, 2004 | |
| Lee Rochholz |
Corporate Director |
Jul 1, 2024 | |
| Adventist Health System Sunbelt Inc |
5% Or Greater Indirect Ownership Interest | Nov 1, 2002 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20181218002591 | KS | Part a Provider - Hospital | 1153239298 | Practice locations: Merriam, KS |
National Provider Directory
- Tax ID family
- Mid America Physicians
- Part of
- Mid America Physicians
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital Unit | 273R00000X | H046004 | KS | Yes |
Addresses
Primary practice location
9100 W 74TH St
Merriam, KS 66204-4004
Mailing address
9100 W 74TH St
Merriam, KS 66204-4004
Phone (913) 676-2000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100017 | Other | FH HEALTH CARE SYSTEM |
Other names
- AdventHealth Shawnee Mission IP Psych
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler | Other | CMS HIH |
Other providers in Merriam, KS
- Kimberly Kay Shara
- Michael J Shara
- Shawnee Mission Health Care, Inc
- Shawnee Mission Medical Center Inc
- Shawnee Mission Medical Center Inc
- Shawnee Mission Medical Center Inc
- Shawnee Mission Surgery Center LLC
- Kara Shelman
- Randy M Sheridan
- Shayna Sheridan
All providers in Merriam, KS · Psychiatric Hospital Unit in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.