PETERSON ASSISTED LIVING, LLC
NPI 1003442062
Assisted Living Facility in Osage City, KS

Active since March 20, 2020CLIA 17D0972058 · Waiver
629 HOLLIDAY ST, OSAGE CITY, KS 66523(785) 528-3301(785) 528-1124 Get Directions Write a Review

NPPES record last updated: March 20, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Peterson Assisted Living, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PETERSON ASSISTED LIVING, LLC (NPI 1003442062) is a healthcare organization registered as an assisted living facility in Osage City, Kansas and active in the NPI registry since March 2020. The organization holds a CLIA Waiver certificate valid through March 27, 2028 and lists Patricia Kay Gundy, Operator/owner, as its authorized official.

NPPES Registry Identity

NPI1003442062
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NamePETERSON ASSISTED LIVING, LLC
Location Address629 HOLLIDAY STOsage City, KS 66523-1137
Mailing Address629 Holliday StOsage City, KS 66523-1137 · (785) 528-3301 · Fax (785) 528-1124
Fax(785) 528-1124
Organization SubpartNo
Authorized OfficialPatricia Kay GundyOperator/owner · (785) 528-3301
Enumeration DateMarch 20, 2020
NPPES CertifiedMarch 20, 2020
NPI 1003442062 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
629 HOLLIDAY ST, Osage City, KS 66523

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 17D0972058

Peterson Assisted Living · Osage City, KS
Active · expires Mar 27, 2028
CLIA Number17D0972058
Laboratory TypeOther
Certificate Effective DateMarch 28, 2026
Certificate Expiration DateMarch 27, 2028
Laboratory DirectorJulie T. Laurance
Laboratory Phone(785) 528-3301
Laboratory LocationPeterson Assisted Living629 Holliday St, Osage City, KS 66523
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapy Assistant
629 HOLLIDAY ST
OSAGE CITY, KS 66523
Assisted Living Facility
629 HOLLIDAY ST
OSAGE CITY, KS 66523

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Peterson Assisted Living, LLC's NPI number?

The NPI number for Peterson Assisted Living, LLC is 1003442062. It was assigned to this organization in the NPPES registry on March 20, 2020.

Where is Peterson Assisted Living, LLC located?

Peterson Assisted Living, LLC is located at 629 Holliday St, Osage City, KS 66523. The listed phone number is (785) 528-3301.

What is Peterson Assisted Living, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Peterson Assisted Living, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 17D0972058) is associated with this NPI, valid through March 27, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Peterson Assisted Living, LLC was last updated on March 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.