Cheney Golden Age Home, Inc.

Key facts

NPI: 1790770287
Entity type: Organization (NPI type 2)
Primary specialty: Skilled Nursing Facility 314000000X
License: 100108890A (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
Organization subpart: No

Authorized official

Name: Jessica Martin
Title: Administrator
Phone: (316) 540-3691

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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)

Medicare Care Compare: Nursing home

Listed as: Cheney Golden Age Home CCN 175399
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: Active (Provider of Services file)
Certified beds: 40 · 37.4 residents per day on average

Source: Medicare Care Compare, processed Aug 1, 2026.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
17D0648290	Cheney Golden Age Home 724 N Main St, Cheney, KS 67025	Certificate of waiver	Aug 31, 2026

Medicare participation

Medicare fee-for-service enrollment: Enrolled in KS

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: Corporation · Non-profit
Enrollment address: 724 N Main St
Cheney, KS 67025-9059
Nursing home name: CHENEY GOLDEN AGE HOME

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.

Name	Role	Since
Individual	Adp of the SNF	Dec 10, 2024
Linda Ball Individual	Managing Control - Governing Body Vice President	Nov 26, 2018
Linda Ball Individual	Trustee of the SNF	Nov 26, 2018
Paula Voth Individual	Managing Control - Governing Body Board Treasurer	May 29, 2018
Paula Voth Individual	Trustee of the SNF	May 26, 2018
Linda Beauchamp Individual	Managing Control - Governing Body Board Member	Aug 24, 2020
Linda Beauchamp Individual	Trustee of the SNF	Aug 24, 2020
Cheney Golden Age Home Inc Organization · Cheney, KS Corporation, Medical provider/supplier, Non-profit	Other	Sep 1, 1966
	Adp of the SNF	Dec 10, 2024
	Direct Ownership Interest	Sep 1, 1966
Glen Kohler Individual	Corporate Officer President of the Board of Directors	Jan 1, 2006
Glen Kohler Individual	Trustee of the SNF	Jan 1, 2006
Cheryl Locke Individual	Managing Control - Governing Body Board Member	Jul 29, 2024
Cheryl Locke Individual	Trustee of the SNF	Jul 29, 2024
Nicky Jones Individual	W-2 Managing Employee Director of Nursing	Jan 1, 2020
Nicky Jones Individual	Adp of the SNF	Dec 10, 2024
Jessica Martin Individual	Corporate Director Administrator	Aug 18, 2023
	W-2 Managing Employee Ad;	Aug 18, 2024
	Adp of the SNF	Dec 10, 2024
Jason Middleton Individual	Managing Control - Governing Body Board Member	Jun 9, 2022
Jason Middleton Individual	Trustee of the SNF	Jun 9, 2022
Terry Kohler Individual	Managing Control - Governing Body Board Member	Mar 8, 2021
Terry Kohler Individual	Trustee of the SNF	Mar 8, 2021

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20060828000178	KS	Part a Provider - Skilled Nursing Facility	6103820550	Practice locations: Cheney, KS

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Nursing Facility/Intermediate Care Facility	313M00000X	100108890A	KS
Skilled Nursing Facility	314000000X	100108890A	KS	Yes

Addresses

Primary practice location

724 N Main St
Cheney, KS 67025-9059

Mailing address

PO Box 370
Cheney, KS 67025-0370
Phone (316) 540-3691

Other identifiers

Identifier	Type	State	Issuer
100108890A	Medicaid	KS

Other providers in Cheney, KS

All providers in Cheney, 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 Oct 16, 2024. 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.

Verify at the official NPI Registry.