CCRC OF LEES SUMMIT, LLC
NPI 1205528353
Skilled Nursing Facility in Lee's Summit, MO

Active since May 25, 2023CLIA 26D2313366 · Waiver
1501 SW ARBORWALK BLVD, LEE'S SUMMIT, MO 64082(913) 599-5705(913) 890-4789 Get Directions Write a Review

NPPES record last updated: March 17, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 17, 2025, Jul 14, 2023, May 25, 2023 (3 updates tracked since 2023).

  • Organization
  • Skilled Nursing Facility
  • CLIA Number: 26D2313366
  • CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
  • CLIA Exp. Date: 10-29-2026

About CCRC OF LEES SUMMIT, LLC

This page provides the complete NPI Profile along with additional information for Ccrc Of Lees Summit, Llc, a provider established in Lee's Summit, Missouri operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1205528353 assigned on May 2023. The practitioner's primary taxonomy code is 314000000X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Gilbert R Wood (Manager Of The Llc)

NPI
1205528353 Verify this NPI
Provider Name
CCRC OF LEES SUMMIT, LLC
Other Name Type
(6)
Entity Type
Organization
Location Address
1501 SW ARBORWALK BLVD LEE'S SUMMIT, MO 64082
Location Phone
(913) 599-5705
Location Fax
(913) 890-4789
Mailing Address
6731 W 121ST ST STE 100 OVERLAND PARK, KS 66209
Mailing Phone
(913) 890-4780
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-25-2023
Last Update Date
03-17-2025
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Skilled Nursing Facility

Taxonomy Code
314000000X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

GILBERT R WOOD

Authorized Official Title
MANAGER OF THE LLC
Authorized Official Phone
(913) 599-5705

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
26D2313366
Facility Type
Skilled Nursing Facility/Nursing Facility
Certificate Effective Date
October 30, 2024
Certificate Expiration Date
October 29, 2026
Laboratory Director
CODY HUGHES
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Ccrc Of Lees Summit, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1205528353, enumerated as an "organization" on May 25, 2023.

The provider is located at 1501 SW ARBORWALK BLVD LEE'S SUMMIT, MO 64082 and the phone number is (913) 599-5705.

Skilled Nursing Facility with taxonomy code 314000000X.