Homestead of Russell Operations, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

N084007 Issued in KS

Legal business name

HOMESTEAD OF RUSSELL OPERATIONS, LLC

Practice address

1070 E Wichita Ave
Russell, KS 67665-2409

Phone

(785) 483-5882

Fax

(785) 483-2797

NPI assigned

Jan 4, 2017

Organization subpart

No

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

Authorized official

Name

Michael D Tryon, CPA

Title

Cfo

Phone

(785) 272-1535

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Homestead of Russell Doing business as

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

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

{
    "created_epoch": "1483488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483488000000",
    "number": "1992240675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3715 SW 29TH ST STE 200",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666142164",
            "telephone_number": "785-272-1535",
            "fax_number": "785-272-1480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 E WICHITA AVE",
            "city": "RUSSELL",
            "state": "KS",
            "postal_code": "676652409",
            "telephone_number": "785-483-5882",
            "fax_number": "785-483-2797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMESTEAD OF RUSSELL OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-04",
        "last_updated": "2017-01-04",
        "status": "A",
        "authorized_official_last_name": "TRYON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "785-272-1535",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "KS",
            "license": "N084007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N084007",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Homestead of Russell",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tatum Lynn Hamilton
• Kaelyn Heller, RBT
• Lataya Heroneme
• Hannah Ruth Herres
• Brendin Higgins
• Chauncy Hucke
• Adleigh Rene Humburg
• Andrew Francis Hurla, MS, ATC, LAT
• Hutchinson Health Care Services Inc
• Tattiana Lynette Inyard

• Assisted Living Facility in Russell, KS
• Providers in Russell, 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 Jan 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.