Moundridge Manor Inc.

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

N059003 Issued in KS

Legal business name

MOUNDRIDGE MANOR INC.

Practice address

710 North Christian Avenue
Moundridge, KS 67107

Phone

(620) 345-6364

Fax

(620) 345-6376

NPI assigned

Feb 22, 2006

Last updated

Jun 16, 2015By 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

Mr. Kevin W Unruh

Title

Administrator

Phone

(620) 345-6364

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972578037. Details of each certification follow.

• CCN 175553 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 175553

Legal name

MOUNDRIDGE MANOR INC

Doing business as

MOUNDRIDGE MANOR

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Dec 23, 2015

Last certification

Sep 25, 2024

Beds

78

Ownership / control type

Church Related

Organization structure

CorporationNon-profit

Enrollment address

710 N Christian Ave
Moundridge, KS 67107-8802

Nursing home name

MOUNDRIDGE MANOR

Listed as

Moundridge ManorCCN 175553 · All quality measures

Overall star rating

5 of 5

Health inspections

4 of 5

Staffing

5 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Church related

Certified

Dec 23, 2015

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

7876.1 residents per day on average

Penalties (3 years)

1Fines totaling $20,295

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 54

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

Owners & managing parties with NPI records 3

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

• Olivia Gehring, MD

  • Family Medicine Physician
  • Moundridge, KS
  • NPI 1013539592

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Mercy Hospital Inc

  • Rural Acute Care Hospital
  • Moundridge, KS
  • NPI 1083628911

  Adp of the SNF

  CMS ownership
• Mercy Hospital Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Moundridge, KS
  • NPI 1285640912

  Adp of the SNF

  CMS ownership

Facilities with the same owner 2

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

• Mercy Hospital Inc

  • Rural Acute Care Hospital
  • Moundridge, KS
  • NPI 1083628911

  Church of God in Christ Mennonite

  CMS ownership
• Mercy Hospital Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Moundridge, KS
  • NPI 1285640912

  Church of God in Christ Mennonite

  CMS ownership

Practitioners 4

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.

• Olivia Gehring, MD

  • Family Medicine Physician
  • Moundridge, KS
  • NPI 1013539592
  NPD (past)
• James D Ratzlaff, M.D.

  • Family Medicine Physician
  • Moundridge, KS
  • NPI 1235134156
  NPD (past)
• Bal K Sharma, MD

  • Psychiatry Physician
  • Wellington, KS
  • NPI 1851352470
  NPD (past)
• Paul D Ullom-Minnich, M.D.

  • Family Medicine Physician
  • Moundridge, KS
  • NPI 1326043241
  NPD (past)

Affiliated clinicians 6

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

• Olivia Gehring, MD

  • Family Medicine Physician
  • Moundridge, KS
  • NPI 1013539592

  Nursing home

  Care Compare affiliation
• Kathryn R Hayes, M.D.

  • Family Medicine Physician
  • Moundridge, KS
  • NPI 1205831146

  Nursing home

  Care Compare affiliation
• Jordan Nikole Leatherman, MD

  • Family Medicine Physician
  • Wichita, KS
  • NPI 1417688870

  Nursing home

  Care Compare affiliation
• James D Ratzlaff, M.D.

  • Family Medicine Physician
  • Moundridge, KS
  • NPI 1235134156

  Nursing home

  Care Compare affiliation
• Marla R Ullom-Minnich, M.D.

  • Family Medicine Physician
  • Moundridge, KS
  • NPI 1073518999

  Nursing home

  Care Compare affiliation
• Paul D Ullom-Minnich, M.D.

  • Family Medicine Physician
  • Moundridge, KS
  • NPI 1326043241

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434412800000",
    "number": "1972578037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 800",
            "city": "MOUNDRIDGE",
            "state": "KS",
            "postal_code": "67107",
            "telephone_number": "620-345-6364",
            "fax_number": "620-345-6376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 NORTH CHRISTIAN AVENUE",
            "city": "MOUNDRIDGE",
            "state": "KS",
            "postal_code": "67107",
            "telephone_number": "620-345-6364",
            "fax_number": "620-345-6376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNDRIDGE MANOR INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-22",
        "last_updated": "2015-06-16",
        "status": "A",
        "authorized_official_last_name": "UNRUH",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "620-345-6364",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "KS",
            "license": "N059003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100109430A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anna Grace Miller, OTD
• Moundridge Dental Center Chartered
• Moundridge Dental, P.a.
• Moundridge Usd423
• New Beginnings Counseling and Educational Services
• Partners in Family Care LLC
• Pathfinders Physical Therapy & Consulting, P.a.
• Ashlee Nicholle Pauls, P.A.-C

• Nursing Facility/Intermediate Care Facility in Moundridge, KS
• Providers in Moundridge, 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 16, 2015; 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.