Lighthouse Rehabilitation LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

LIGHTHOUSE REHABILITATION LLC

Practice address

Clearwater Retirement Community
620 East Wood Street
Clearwater, KS 67026

Phone

(620) 584-2271

NPI assigned

Mar 8, 2007

Organization subpart

No

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

Authorized official

Name

Eddie A LightNPI 1275707911

Title

Ceo

Phone

(316) 522-1095

Specialties & licenses 1

Addresses

Practitioners 5

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

• Eddie Light

  • Physical Therapy Assistant
  • Haysville, KS
  • NPI 1275707911
  NPD (past) Authorized official
• Sandra Dawn Beers, PT

  • Physical Therapist
  • Bel Aire, KS
  • NPI 1023163458
  NPD (past)
• Kim C Heiskell, OTR

  • Occupational Therapist
  • Clearwater, KS
  • NPI 1396876504
  NPD (past)
• Janet L Korte, RPT

  • Physical Therapist
  • Haysville, KS
  • NPI 1942493200
  NPD (past)
• Kim Reiman

  • Physical Therapist
  • Clearwater, KS
  • NPI 1750412631
  NPD (past)

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861523086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981 FOREST CT",
            "city": "HAYSVILLE",
            "state": "KS",
            "postal_code": "670601478",
            "telephone_number": "316-522-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CLEARWATER RETIREMENT COMMUNITY",
            "address_2": "620 EAST WOOD STREET",
            "city": "CLEARWATER",
            "state": "KS",
            "postal_code": "67026",
            "telephone_number": "620-584-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LIGHT",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "316-522-1095"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gracemed Health Clinic, Inc
• Richard Grizzle, EMT
• Kim C Heiskell, OTR
• Veronica Herrera
• Elizabeth Ann House, PHYSICAL THERAPIST
• Carol Manes, RN
• Karl L May, D.C.
• Nancy Milledge
• Brianne Montes
• Lila M Mourning, ARNP-C

• All providers in Clearwater, KS
• Skilled Nursing Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.