NPIMap

Organization Active NPI

Shawnee Mission Medical Center Inc

  • Psychiatric Hospital Unit
  • Merriam, KS
National Provider Identifier
1720142565
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
H046004 Issued in 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
Last updated
Dec 17, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SHAWNEE MISSION MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Authorized official

Name
Stephanie Rosentreter
Title
Cfo
Phone
(620) 249-2457

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X H046004 KS Primary

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 names 1

  • AdventHealth Shawnee Mission IP Psych Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other CMS HIH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181218002591 KS Part A Provider - Hospital 1153239298 Practice locations: Merriam, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720142565. Details of each certification follow.

Hospital certification: CCN 17S104

Legal name
SHAWNEE MISSION MEDICAL CENTER INC
Doing business as
ADVENTHEALTH SHAWNEE MISSION IP PSYCH
Organization structure
CorporationNon-profit
Enrollment address
9100 W 74TH St
Merriam, KS 66204-4004
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Sunflower Medical GRP PA19 organizations share this tax ID, including this one
Part of
Sunflower Medical GRP PA

Other organizations with this tax ID 18

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

View all 18

Ownership & related parties

All disclosed owners & managing parties 28

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

NameRoleSinceShare
Gary Thurber Individual Corporate DirectorDirector Sep 17, 2015
David Vandevere Individual Corporate DirectorDirector Dec 12, 2023
Gregory Maddux Individual Corporate DirectorDirector Jan 1, 2006
Samuel Caughron Individual Corporate DirectorDirector Dec 12, 2023
Timothy R. Rodgers Individual Corporate OfficerDirector / Vice Chairperson May 25, 2021
Corporate DirectorDirector / Vice Chairperson Jan 1, 2020
Reagan M Wittek Individual Corporate DirectorDirector Dec 12, 2019
Karsten Randolph Individual Contracted Managing EmployeeDirector / Assistant Secretary Apr 1, 2014
Corporate OfficerDirector / Assistant Secretary Apr 1, 2014
Corporate DirectorDirector / Assistant Secretary Apr 1, 2014
Barbara Cusick Individual Corporate DirectorDirector Feb 24, 2011
Adventisit Health Mid-America Inc Organization, Merriam, KS Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Nov 1, 2011 100%
Andrew D Jahn Individual Corporate DirectorDirector Apr 1, 2024
Abigail R Proffer Individual Corporate DirectorDirector Dec 12, 2023
Twyla Rist Individual Corporate DirectorDirector Dec 12, 2023
Sam Huenergardt Individual Corporate DirectorDirector Jun 7, 2018
Michael Saunders Individual Corporate OfficerAssistant Secretary Feb 22, 2007
Paul C Rathbun Individual Corporate OfficerAssistant Secretary Sep 11, 2014
Stephen Williams Individual Corporate DirectorDirector Dec 12, 2023
Adventist Health System Sunbelt Healthcare Corporation Organization, Altamonte Springs, FL Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Nov 1, 2002 100%
Lyle Pishny Individual Corporate DirectorDirector Jan 29, 2008
Ronald Carlson Individual Corporate DirectorDirector Jan 1, 2006
Amanda Brady Individual 5% Or Greater Indirect Ownership Interest Nov 1, 2002 100%
Alan David Verrill Individual Contracted Managing EmployeeCeo/Director/ Secretary Feb 25, 2024
Corporate OfficerCeo/Director/ Secretary Feb 12, 2023
Corporate DirectorCeo/Director/ Secretary Feb 25, 2024
Operational/Managerial ControlCeo/Director/ Secretary Feb 25, 2024
Toni Berrios Individual Corporate OfficerAssistant Secretary Jun 1, 2024
Stephanie Rosentreter Individual Contracted Managing EmployeeCfo Oct 5, 2025
Corporate OfficerCfo Oct 5, 2025
Operational/Managerial ControlCfo Oct 5, 2025
David L Huffman Individual Corporate OfficerAssistant Secretary Dec 12, 2019
Roger Bernard Individual Corporate DirectorDirector Jun 9, 2016
Lynn Addiscott Individual Corporate OfficerAsst Secretary Jan 26, 2004
Lee Rochholz Individual Corporate DirectorDirector Jul 1, 2024
Adventist Health System Sunbelt Inc Organization, Altamonte Springs, FL Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Nov 1, 2002 100%

Owners & managing parties with NPI records 3

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

Facilities with the same owner 88

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

View all 88

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": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765929600000",
    "number": "1720142565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 W 74TH ST",
            "city": "MERRIAM",
            "state": "KS",
            "postal_code": "662044004",
            "telephone_number": "913-676-2000",
            "fax_number": "913-676-7571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 W 74TH ST",
            "city": "MERRIAM",
            "state": "KS",
            "postal_code": "662044004",
            "telephone_number": "913-676-2000",
            "fax_number": "913-676-7571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWNEE MISSION MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHAWNEE MISSION MEDICAL CENTER",
        "enumeration_date": "2006-12-19",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A",
        "authorized_official_last_name": "ROSENTRETER",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "620-249-2457"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "KS",
            "license": "H046004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "CMS HIH",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "7500 Security Blvd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212441849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "AdventHealth Shawnee Mission IP Psych",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Merriam, KS

Sources for this page

Verify at the official NPI Registry.