Maize CCRC, LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

N087046 Issued in KS

Legal business name

MAIZE CCRC, LLC

Doing business as

Park West Plaza

Practice address

505 N Maize Rd
Wichita, KS 67212-4689

Phone

(316) 729-4114

NPI assigned

Jun 7, 2013

Organization subpart

Yes

Parent organization

JUPITER TENANT, LLCAs reported in NPPES

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

Authorized official

Name

Mr. Christopher Wettig

Title

Cfo

Phone

(316) 616-6288

Specialties & licenses 1

Addresses

Other names 1

• Park West Plaza Doing business as

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

CLIA laboratory certificates

Part of

Maize CCRC LLC

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

{
    "created_epoch": "1370563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370563200000",
    "number": "1922446350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8415 E 21ST ST N STE 100",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672062959",
            "telephone_number": "316-616-6288",
            "fax_number": "316-616-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N MAIZE RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672124689",
            "telephone_number": "316-729-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIZE CCRC, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JUPITER TENANT, LLC",
        "enumeration_date": "2013-06-07",
        "last_updated": "2013-06-07",
        "status": "A",
        "authorized_official_last_name": "WETTIG",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "316-616-6288",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "KS",
            "license": "N087046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park West Plaza",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alec Jean Mailloux
• Joseph Njuku Maina, FNP
• Lillian Nyakairu Maina, LMSW
• Sandhya Mainali, MD
• Linda Marie Mainzer, RRT
• Maize Dental Studio PA
• Bradford D Majher, O.D.
• Mark Andrew Majher, CLVT
• Christopher A Majors, DDS
• Janey E. Maki, MD

• Nursing Facility/Intermediate Care Facility in Wichita, KS
• Providers in Wichita, KS by specialty
• Nursing Facility/Intermediate Care Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.