Cheney Golden Age Home, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

100108890A Issued in KS

Legal business name

CHENEY GOLDEN AGE HOME, INC.

Practice address

724 N Main St
Cheney, KS 67025-9059

Phone

(316) 540-3691

Fax

(316) 542-0165

NPI assigned

Sep 12, 2005

Last updated

Oct 16, 2024By 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

Jessica Martin

Title

Administrator

Phone

(316) 540-3691

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790770287. Details of each certification follow.

• CCN 175399 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 175399

Legal name

CHENEY GOLDEN AGE HOME INC

Doing business as

CHENEY GOLDEN AGE HOME

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Dec 1, 1996

Last certification

Nov 18, 2024

Beds

45 (40 certified)

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Enrollment address

724 N Main St
Cheney, KS 67025-9059

Nursing home name

CHENEY GOLDEN AGE HOME

Listed as

Cheney Golden Age HomeCCN 175399 · All quality measures

Overall star rating

3 of 5

Health inspections

3 of 5

Staffing

4 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Dec 1, 1996

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

4037.4 residents per day on average

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 11

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

Practitioners 3

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.

• Susan Marie Giovanni, D.O.

  • Family Medicine Physician
  • Wichita, KS
  • NPI 1689616203
  NPD (past)
• Nancy Jo Hageman, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Cheney, KS
  • NPI 1124200829
  NPD (past)
• Richard E Liepins, DO

  • Family Medicine Physician
  • Wichita, KS
  • NPI 1972566073
  NPD (past)

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1790770287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "CHENEY",
            "state": "KS",
            "postal_code": "670250370",
            "telephone_number": "316-540-3691",
            "fax_number": "316-542-0165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 N MAIN ST",
            "city": "CHENEY",
            "state": "KS",
            "postal_code": "670259059",
            "telephone_number": "316-540-3691",
            "fax_number": "316-542-0165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHENEY GOLDEN AGE HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-12",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "316-540-3691"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "KS",
            "license": "100108890A",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KS",
            "license": "100108890A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100108890A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Lee Cantrell, LPC
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• Cheney Physical Therapy and Sports Performance
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• Hope Cramer, DPT
• Mary K Goodwin, MD
• Gould Chiropractic Cheney Health Center (CPRS)

• Skilled Nursing Facility in Cheney, KS
• Providers in Cheney, 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 Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.