The Village at Mission LLC
Organization Active NPI Skilled Nursing Facility · Prairie Village, KS
NPI 1770166472 · NPPES record last updated Dec 30, 2021
Key facts
- NPI
- 1770166472
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- THE VILLAGE AT MISSION LLC
- Practice address
- 7105 Mission Rd
Prairie Village, KS 66208-3000 - Phone
- (913) 262-1611
- Fax
- (913) 262-0204
- NPI assigned
- Apr 30, 2021
- Organization subpart
- No
Authorized official
- Name
- Joseph C Tutera
- Title
- Sole MBR
- Phone
- (816) 444-0900
Facilities with the same owner 21
Practitioners 3
-
Maninder Pabla, MD
-
Cameron Lee Smith, D.O.
Affiliated clinicians 2
-
Janet Eileen Morgan, M.D.
-
Maninder Pabla, MD
Medicare Care Compare: Nursing home
- Listed as
- The Village at Mission
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jun 20, 2007
- Medicare certification status
- Active
- Certified beds
- 60 · 50.1 residents per day on average
- Chain
- Tutera Senior Living & Health Care
- Penalties (3 years)
- 1 · fines totaling $14,901
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 17D2204690 | Village at Mission, LLC, the | Certificate of waiver | Dec 9, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Skilled nursing facility certification: CCN 175499
- Legal name
- THE VILLAGE AT MISSION LLC
- Doing business as
- THE VILLAGE AT MISSION
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 20, 2007
- Last certification
- Oct 25, 2023
- Beds
- 168 (60 certified)
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Tutera
- Organization structure
- LLC · Proprietary
- Incorporated
- Feb 8, 2021 in KS
- Enrollment address
- 7105 Mission Road
Prairie Village, KS 66208-3302 - Nursing home name
- THE VILLAGE AT MISSION
- Affiliated entity
- TUTERA SENIOR LIVING & HEALTH CARE
All disclosed owners & managing parties 5
| Name | Role | Since | Share |
|---|---|---|---|
| Jeff Gannon |
Corporate Officer |
Jun 1, 2021 | 5% |
| Operational/Managerial Control |
Jun 1, 2021 | 5% | |
| Joseph C Tutera |
5% Or Greater Direct Ownership Interest | Jun 1, 2021 | 10% |
| 5% Or Greater Security Interest | Jun 1, 2021 | ||
| Corporate Director |
Jun 1, 2021 | 10% | |
| Kiley a Brooks |
Corporate Officer |
Jun 1, 2021 | 5% |
| Operational/Managerial Control |
Jun 1, 2021 | 5% | |
| Walnut Creek Management Company LLC |
Operational/Managerial Control | Jun 1, 2021 | 20% |
| The Village at Mission Property LLC |
5% Or Greater Direct Ownership Interest | Jun 1, 2021 | 40% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211227000026 | KS | Part a Provider - Skilled Nursing Facility | 9133510365 | Practice locations: Prairie Village, KS |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
7105 Mission Rd
Prairie Village, KS 66208-3000
Mailing address
5105 Mission Rd
Westwood, KS 66205-1660
Phone (913) 262-1617
Other names
- The Village at Mission
NPI Registry JSON
{
"created_epoch": "1619740800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1640822400000",
"number": "1770166472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5105 MISSION RD",
"city": "WESTWOOD",
"state": "KS",
"postal_code": "662051660",
"telephone_number": "913-262-1617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7105 MISSION RD",
"city": "PRAIRIE VILLAGE",
"state": "KS",
"postal_code": "662083000",
"telephone_number": "913-262-1611",
"fax_number": "913-262-0204"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THE VILLAGE AT MISSION LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-04-30",
"last_updated": "2021-12-30",
"certification_date": "2021-12-30",
"status": "A",
"authorized_official_last_name": "TUTERA",
"authorized_official_first_name": "JOSEPH",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "SOLE MBR",
"authorized_official_telephone_number": "816-444-0900"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "The Village at Mission",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "The Village at Mission",
"code": "3",
"type": "Doing Business As"
}
]
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All providers in Prairie Village, KS · Skilled Nursing Facility 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 30, 2021. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.