Providence Place, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

N105013 Issued in KS

Legal business name

PROVIDENCE PLACE, INC.

Practice address

8909 Parallel Pkwy
Kansas City, KS 66112-1689

Phone

(913) 596-4200

Fax

(913) 596-4904

NPI assigned

Jun 10, 2005

Last updated

Apr 26, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mike Warren

Title

Administrator

Phone

(913) 596-4200

Specialties & licenses 1

Addresses

Other identifiers 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Prime Healthcare Services-Providence, LLC

  dba Providence Medical Center

  • General Acute Care Hospital
  • Kansas City, KS
  • NPI 1528301900

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366934400000",
    "number": "1750385217",
    "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": "913-596-4200",
            "fax_number": "913-596-4904"
        },
        {
            "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": "913-596-4200",
            "fax_number": "913-596-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE PLACE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-10",
        "last_updated": "2013-04-26",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "913-596-4200"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KS",
            "license": "N105013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200972460A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cormac Prosser, MD
• Providence Cardiothoracic Associates
• Providence Care Inc
• Providence Medical Center, Inc
• Providence Medical Group
• Patrick P Pruitt, LCSW
• Stephanie Lynn Prusa, DENTAL HYGIENIST
• Hannah Prymek, ATC
• Elizabeth Kent Pryor, MD
• James R Pryor, DNP, APRN

• Skilled Nursing Facility in Kansas City, KS
• Providers in Kansas City, KS by specialty
• Skilled Nursing Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2013; 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.