Wilshire Operator LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

WILSHIRE OPERATOR LLC

Doing business as

Wilshire at Lakewood Rehab Center

Practice address

600 NE Meadowview Dr
Lees Summit, MO 64064-1983

Phone

(816) 554-9866

NPI assigned

Dec 3, 2021

Last updated

Dec 3, 2021By 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

Jacques Wolf

Title

Manager

Phone

(908) 621-1184

Specialties & licenses 1

Addresses

Other names 1

• Wilshire at Lakewood Rehab Center Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972261287. Details of each certification follow.

• CCN 265700 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 265700

Legal name

WILSHIRE OPERATOR LLC

Doing business as

WILSHIRE AT LAKEWOOD REHAB CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF distinct part

Participating since

Jun 18, 1999

Last certification

Nov 21, 2023

Beds

170

Ownership / control type

Limited Liability Corporation

Organization structure

LLCProprietary

Incorporated

Sep 2, 2021 in MO

Enrollment address

600 NE Meadowview Dr
Lees Summit, MO 64064-1983

Nursing home name

WILSHIRE AT LAKEWOOD REHAB CENTER

Affiliated entity

AMA HOLDINGS

Listed as

Wilshire at Lakewood Rehab CenterCCN 265700 · All quality measures

Overall star rating

3 of 5

Health inspections

4 of 5

Staffing

1 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jun 18, 1999

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

170131.7 residents per day on average

Chain

Ama Holdings13 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 6

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

Facilities with the same owner 12

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Beauvais Operator LLC

  dba Beauvais Rehab and Healthcare Center

  • Skilled Nursing Facility
  • Saint Louis, MO
  • NPI 1285308031

  Ama Holdings LLC, Def Holdings LLC, Mo Operation Holdings de Spe LLC

  CMS ownership
• Butler Operator LLC

  dba Butler Rehab and Healthcare Center

  • Skilled Nursing Facility
  • Butler, MO
  • NPI 1619669645

  Ama Holdings LLC, Def Holdings LLC

  CMS ownership
• Carriage Operator LLC

  dba Carriage Square Rehab and Healthcare Center

  • Skilled Nursing Facility
  • Saint Joseph, MO
  • NPI 1780358473

  Ama Holdings LLC, Def Holdings LLC, Mo Operation Holdings de Spe LLC

  CMS ownership
• Country Club Operator LLC

  dba Country Club Rehab and Healthcare Center

  • Skilled Nursing Facility
  • Warrensburg, MO
  • NPI 1104584416

  Ama Holdings LLC, Def Holdings LLC, Mo Operation Holdings de Spe LLC

  CMS ownership
• Crown Operator LLC

  dba Crown Rehab and Healthcare Center

  • Skilled Nursing Facility
  • Harrisonville, MO
  • NPI 1073271383

  Ama Holdings LLC, Def Holdings LLC, Mo Operation Holdings de Spe LLC

  CMS ownership
• Manchester Operator LLC

  dba Manchester Rehab and Healthcare Center

  • Skilled Nursing Facility
  • Ballwin, MO
  • NPI 1730871765

  Ama Holdings LLC, Def Holdings LLC

  CMS ownership
• New Mark Operator LLC

  dba New Mark Rehab and Healthcare Center

  • Skilled Nursing Facility
  • Kansas City, MO
  • NPI 1750114880

  Ama Holdings LLC, Def Holdings LLC

  CMS ownership
• Rancho Operator LLC

  dba Rancho Rehab and Healthcare Center

  • Skilled Nursing Facility
  • Florissant, MO
  • NPI 1821762691

  Ama Holdings LLC, Def Holdings LLC, Mo Operation Holdings de Spe LLC

  CMS ownership
• River Crossing Operator LLC

  dba River Crossing Rehab and Healthcare Center

  • Skilled Nursing Facility
  • Saint Louis, MO
  • NPI 1144094608

  Ama Holdings LLC, Def Holdings LLC

  CMS ownership
• Rosewood Operator LLC

  dba Rosewood Rehab and Healthcare Center

  • Skilled Nursing Facility
  • Independence, MO
  • NPI 1669146361

  Ama Holdings LLC, Def Holdings LLC, Mo Operation Holdings de Spe LLC

  CMS ownership
• Seasons Operator LLC

  dba Seasons Rehab and Healthcare Center

  • Skilled Nursing Facility
  • Kansas City, MO
  • NPI 1861166563

  Ama Holdings LLC, Def Holdings LLC, Mo Operation Holdings de Spe LLC

  CMS ownership
• St Peters Operator LLC

  dba St Peters Rehab and Healthcare Center

  • Skilled Nursing Facility
  • Saint Peters, MO
  • NPI 1861254948

  Ama Holdings LLC, Def Holdings LLC

  CMS ownership

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Malathi Tadakamalla, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Lee's Summit, MO
  • NPI 1316989197
  NPD (past)
• Kathryn Clare Twenter, D.O.

  • Internal Medicine Physician
  • Lee's Summit, MO
  • NPI 1841229200
  NPD (past)

Affiliated clinicians 2

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

• Malathi Tadakamalla, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Lee's Summit, MO
  • NPI 1316989197

  Nursing home

  Care Compare affiliation
• Kathryn Clare Twenter, D.O.

  • Internal Medicine Physician
  • Lee's Summit, MO
  • NPI 1841229200

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1638489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638489600000",
    "number": "1972261287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 BLVD OF THE AMERICAS",
            "address_2": "SUITE 201",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "08701",
            "telephone_number": "908-621-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NE MEADOWVIEW DR",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640641983",
            "telephone_number": "816-554-9866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSHIRE OPERATOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-03",
        "last_updated": "2021-12-03",
        "certification_date": "2021-11-21",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "JACQUES",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "908-621-1184"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilshire at Lakewood Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sharon L Williams
• Tara C. Williams, BCBA
• Zachary Thomas Williams, D.D.S., M.C.L.D.
• Emily Ann Williamson, LMSW
• Katie Willis, LCSW
• Barry Scott Wilson, D.C.
• Crosby Wilson
• David Wilson, RPH
• David Demetrius Wilson, DC, MS
• Haley Nicole Wilson, PT, DPT

• Skilled Nursing Facility in Lee's Summit, MO
• Providers in Lee's Summit, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.