Precious Gems Homes @ Polo Dr

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PRECIOUS GEMS HOMES @ POLO DR

Practice address

5502 Polo Dr
Wichita, KS 67208-2752

Phone

(774) 361-4056

NPI assigned

Oct 27, 2020

Last updated

Oct 27, 2020By 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

Syreeta Dweh-Chenneh

Title

Nurse/Operation

Phone

(177) 436-1405

Specialties & licenses 1

Addresses

Other names 1

• Precious Gems Homes @ Polo Dr Other name

Electronic endpoints 1

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603756800000",
    "number": "1942800198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5502 POLO DR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672082752",
            "telephone_number": "774-361-4056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5502 POLO DR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672082752",
            "telephone_number": "774-361-4056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECIOUS GEMS HOMES @ POLO DR",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-27",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A",
        "authorized_official_last_name": "DWEH-CHENNEH",
        "authorized_official_first_name": "SYREETA",
        "authorized_official_title_or_position": "NURSE/OPERATION",
        "authorized_official_telephone_number": "177-436-1405"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "sbulgin1977@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Assistant living",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "useOtherDescription": "Assistant living",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "Assistant living",
            "address_1": "1822 N Brunswick St",
            "city": "Wichita",
            "state": "KS",
            "country_code": "US",
            "postal_code": "672121588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Precious Gems Homes @ Polo Dr",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Assisted Living Facility in Wichita, KS
• Providers in Wichita, KS by specialty
• Assisted Living Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.