NPIMap

Organization Active NPI

Ourkansas Guardian LLC

  • Home Health Agency
  • Wichita, KS
National Provider Identifier
1962977017
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
OURKANSAS GUARDIAN LLC
Practice address
9415 E Harry St, Ste 605
Wichita, KS 67207
Phone
(316) 448-4250
NPI assigned
Oct 4, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Authorized official

Name
Mr. Siegfried MboyaNPI 1154120780
Title
Director of Nursing
Phone
(316) 448-4250

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary
Community Based Hospice Care Agency 251G00000X

Addresses

Primary practice location

9415 E Harry St, Ste 605
Wichita, KS 67207

Mailing address

9415 E Harry St, Ste 605
Wichita, KS 67207
Phone (316) 448-4250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190320001413 KS Part A Provider - Home Health Agency 7911247424 Practice locations: Wichita, KS

Home health agency certification: CCN 178126

Legal name
OURKANSAS GUARDIAN LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 3, 2021
Last certification
Feb 3, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
May 3, 2017 in KS
Enrollment address
2312 S Meridian Ave
Ste 104
Wichita, KS 67213-1912

Care Compare: Home health agency

Medicare Care Compare
Listed as
Ourkansas GuardianCCN 178126
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Feb 3, 2021
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D2170450Ourkansas Guardian Home Health9415 E Harry St, Ste 605, Wichita, KS 67207Certificate of waiverAug 11, 2027

National Provider Directory

National Provider Directory

Locations

9415 E Harry St
Ste 605
Wichita, KS 67207
Phone (316) 448-4250

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Anne Ngaruiya Individual 5% Or Greater Direct Ownership InterestOwner May 3, 2017 50%
Corporate OfficerOwner Board Member President May 3, 2017
Corporate DirectorOwner Board Member President May 3, 2017
W-2 Managing EmployeeOwner Board Member President May 3, 2017
Siegfried Mboya Individual 5% Or Greater Direct Ownership InterestOwner May 3, 2017 50%
Corporate OfficerOwner Board Member Vice Presiden May 3, 2017
Corporate DirectorOwner Board Member Vice Presiden May 3, 2017

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Siegfried Mboya, PMHNP-BC
    • Psychiatric/Mental Health Nurse Practitioner
    • Bel Aire, KS
    • NPI 1154120780

    5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer

    CMS ownership
  • Anne N Ngaruiya
    • Psychiatric/Mental Health Nurse Practitioner
    • Mesa, AZ
    • NPI 1962109785

    5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 2

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

Affiliated clinicians 6

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669075200000",
    "number": "1962977017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9415 E HARRY ST, STE 605",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67207",
            "telephone_number": "316-448-4250",
            "fax_number": "316-219-5849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9415 E HARRY ST, STE 605",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67207",
            "telephone_number": "316-448-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OURKANSAS GUARDIAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-04",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A",
        "authorized_official_last_name": "MBOYA",
        "authorized_official_first_name": "SIEGFRIED",
        "authorized_official_title_or_position": "DIRECTOR OF NURSING",
        "authorized_official_telephone_number": "316-448-4250",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.