Organization Active NPI

Hickory Creek Healthcare LLC

  • Skilled Nursing Facility
  • Kansas City, KS
National Provider Identifier
1982575304
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
HICKORY CREEK HEALTHCARE LLC
Practice address
6500 Greeley Ave
Kansas City, KS 66104-2647
Phone
(913) 334-0200
Fax
(949) 540-3007
NPI assigned
Sep 17, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Authorized official

Name
Soon Burnam
Title
Secretary
Phone
(949) 540-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

6500 Greeley Ave
Kansas City, KS 66104-2647

Mailing address

6500 Greeley Ave
Kansas City, KS 66104-2647
Phone (913) 334-0200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260212002048 KS Part A Provider - Skilled Nursing Facility 0244710937 Practice locations: Kansas City, KS

Skilled nursing facility certification: CCN 175135

Legal name
HICKORY CREEK HEALTHCARE LLC
Doing business as
WILLOW POINT REHABILITATION AND NURSING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 25, 1984
Last certification
Oct 24, 2024
Beds
45
Ownership / control type
Corporation
Multi-facility organization
Medicalodges Inc
Most recent change of ownership
Dec 1, 2025
Organization structure
LLCProprietary
Enrollment address
6500 Greeley Ave
Kansas City, KS 66104-2647
Nursing home name
WILLOW POINT REHABILITATION AND NURSING CENTER
Affiliated entity
THE ENSIGN GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Willow Point Rehabilitation and Nursing CenterCCN 175135
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jul 25, 1984
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5635.4 residents per day on average
Chain
The Ensign Group342 facilities in the chain
Penalties (3 years)
1Fines totaling $15,421
Ownership change
Changed ownership in the last 12 months

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

6500 Greeley Ave
Kansas City, KS 66104
Phone (913) 334-0200

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Corwin Lewis Individual Operational/Managerial Control Feb 1, 2026
Managing Control - Governing BodyAdministrator Feb 1, 2026
Adp of the SNF Feb 1, 2026
Mount Sunflower Health Holdings LLC Organization, San Juan Capistrano, CA LLC Adp of the SNF Dec 1, 2025
Karen L Epperson Individual Operational/Managerial Control Dec 1, 2025
Adp of the SNF Dec 1, 2025
The Ensign Group Inc Organization, San Juan Capistrano, CA Corporation Indirect Ownership Interest Dec 1, 2025 100%
Gateway Healthcare LLC Organization, San Juan Capistrano, CA LLC Direct Ownership Interest Sep 16, 2025 100%
Ensign Services, Inc. Organization, San Juan Capistrano, CA Corporation Adp of the SNF Sep 16, 2025
Standard Bearer Healthcare Op, LP Organization, San Juan Capistrano, CA Adp of the SNF Dec 1, 2025
Soon Burnam Individual Corporate OfficerSecretary Hickory Creek Healthcare Sep 16, 2025
Operational/Managerial Control Sep 16, 2025

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 1

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": "1758067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758067200000",
    "number": "1982575304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 GREELEY AVE",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661042647",
            "telephone_number": "913-334-0200",
            "fax_number": "949-540-3007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 GREELEY AVE",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661042647",
            "telephone_number": "913-334-0200",
            "fax_number": "949-540-3007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HICKORY CREEK HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-17",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.