SOONER GERIATRICS, LLC (NPI# 1164527727) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164527727 |
| Entity Type | Organization |
| Organization Name | SOONER GERIATRICS, LLC |
| Other Organization Name | SOONER GERIATRICS, LLC |
| Practice Address |
1913 Ne 50th St Oklahoma City OK 73111-7003 |
| Mailing Address |
1921 Ne 50th St Oklahoma City OK 73111-2420 |
| Practice Telephone | 4054275414 |
| Practice Fax Number | 4054275432 |
| Mailing Telephone | 4054275414 |
| Mailing Fax Number | 4054275432 |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2020-08-05 |
| Authorized Official Name | KRISTY DEROIN (DIRECTOR OF REIMBURSEMENT) |
| Authorized Official Telephone | 4059431144 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | NH5501-5501 | OK | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100778040A | 05 |
| Other Name | Type Code |
|---|---|
| GRACE LIVING CENTER - WILDEWOOD | Doing Business As Name - Organization |
| Sooner Geriatrics, LLC | Former Legal Business Name - Organization |
| WILDEWOOD SKILLED NURSING AND THERAPY | Doing Business As Name - Organization |
| Street Address |
1913 NE 50TH ST |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73111-7003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689114779 | Brandi N Ridley | Counselor | 3621 N. Kelley Ave Ste. 100, Oklahoma City, OK 73111 | 2017-03-08 |
| 1790134708 | Raymond Arthur Smith Jr. | Counselor | 2329 Nw 111th, Oklahoma, OK 73111 | 2016-06-09 |
| 1124485263 | Oklahoma City County Health Department | Public Health or Welfare | 2700 Ne 63rd Street, Oklahoma City, OK 73111 | 2016-01-20 |
| 1528438710 | Brendel Lacey | Case Manager/Care Coordinator | 3017 N Martin Luther King Avenue, Oklahoma City, OK 73111 | 2015-09-30 |
| 1194108746 | Mary Margaret Mcmiller | Social Worker | 2700 Ne 63rd St, Oklahoma City, OK 73111 | 2015-07-01 |
| 1386037349 | Michelle Patrick | Counselor | 2525 Nw Expressway Suite 531, Building Up People Behavioral Health Service, Oklahoma, OK 73111 | 2015-03-13 |
| 1154764173 | Ne Wellness Community Health Clinic | Clinic/Center | 2600 Ne 63rd Street, Oklahoma City, OK 73111 | 2013-04-09 |
| 1033458070 | Mary Boyles | Case Manager/Care Coordinator | 1732 N Kelly, Oklahoma, OK 73111 | 2013-02-12 |
| 1427312164 | Sharonda Lavon Bowie | Counselor | 1328 Ne 53rd St, Oklahoma City, OK 73111 | 2012-06-27 |
| 1598029373 | Michael Brown | Counselor | 4413 Rock Island Circle, Oklahoma City, OK 73111 | 2012-06-27 |
| Find all providers in zip 73111 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (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. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689029266 | Swalk Operations, LLC | Skilled Nursing Facility | 315 Sw 80th Street, Oklahoma City, OK 73139 | 2016-05-02 |
| 1376775957 | Manor Care of Oklahoma City (northwest) LLC | Skilled Nursing Facility | 5301 N Brookline Ave, Oklahoma City, OK 73112-3516 | 2009-08-17 |
| 1902030570 | City of Pauls Valley | Skilled Nursing Facility | 2333 Tuscany Blvd, Oklahoma City, OK 73120-3702 | 2009-05-11 |
| 1982885265 | Lutheran Senior Citizens, Inc | Skilled Nursing Facility | 7707 W Britton Rd, Oklahoma City, OK 73132-1512 | 2007-11-15 |
| 1124156153 | Bellecare Inc. | Skilled Nursing Facility | 2801 Nw 61st St, Oklahoma City, OK 73112-7007 | 2007-03-01 |
| 1376610972 | Windsor Hills Nursing Center, LLC | Skilled Nursing Facility | 2416 N Ann Arbor Ave, Oklahoma City, OK 73127-1811 | 2006-11-29 |
| 1407923824 | Warr Acres Nursing Center, LLC | Skilled Nursing Facility | 6501 N Macarthur Blvd, Oklahoma City, OK 73132-6505 | 2006-11-29 |
| 1851487508 | Edwards Redeemer Nursing Center, LLC | Skilled Nursing Facility | 1530 Ne Grand Blvd, Oklahoma City, OK 73117-5212 | 2006-10-04 |
| 1295830933 | Brookwood Nursing Center, LLC | Skilled Nursing Facility | 940 Sw 84th St, Oklahoma City, OK 73139-9255 | 2006-09-14 |
| 1174628721 | Terrace Gardens Nursing Center, LLC | Skilled Nursing Facility | 1921 Ne 21st St, Oklahoma City, OK 73111-2420 | 2006-09-14 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73111 |
Please comment or provide details below to improve the information on SOONER GERIATRICS, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.