MEDICARE: CENTERWELL CERTIFIED HEALTHCARE CORP.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251J00000X	Nursing Care Agency
2	252Y00000X	Early Intervention Provider Agency
3	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	60800-62	OTHER	G2
6	000013015J	OTHER	G2
7	7405017	OTHER	G2
8	ANCO15	OTHER	G2
9	1016897	OTHER	G2
10	533	OTHER	G2
11	000000054236	OTHER	G2
12	000000345090	OTHER	G2
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	15324	OTHER	G2
15	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
16	000028220	OTHER	G2
17	187058	OTHER	G2

General Provider Information

NPI Number	:	1831122563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTERWELL CERTIFIED HEALTHCARE CORP.

Provider Business Mailing Address
First Line	:	6330 SPRINT PKWY STE 300
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66211-1157
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2114 CHAMBER CENTER DR
Second Line	:
City	:	FORT MITCHELL
State	:	KY
Zip	:	41017-1669
Country	:	US
Telephone Number	:	859-331-5800
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED SIGNATORY
Name	:	JOHN NICHOLS
Credential	:
Telephone Number	:	859-331-5800

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	01/26/2024

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Directions to “CENTERWELL CERTIFIED HEALTHCARE CORP. ” Practice Location

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