SOUTH LEWIS SH OPCO, LLC (NPI# 1669777892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669777892 |
| Entity Type | Organization |
| Organization Name | SOUTH LEWIS SH OPCO, LLC |
| Practice Address |
5721 S Lewis Ave Tulsa OK 74105-7129 |
| Mailing Address |
1500 Waters Ridge Dr Ste 200 Lewisville TX 75057-6056 |
| Practice Telephone | 9184476447 |
| Practice Fax Number | 9184479661 |
| Mailing Telephone | 9728994126 |
| Enumeration Date | 2011-01-19 |
| Last Update Date | 2020-01-08 |
| Authorized Official Name | JOHN PAUL TAYLOR (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 9728994126 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 310400000X | Assisted Living Facility | CC7207-7207 | OK | Nursing & Custodial Care Facilities |
| N | 313M00000X | Nursing Facility/Intermediate Care Facility | CC7207-7207 | OK | Nursing & Custodial Care Facilities |
| Y | 314000000X | Skilled Nursing Facility | CC7207-7207 | OK | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 200408450A | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | SOUTH LEWIS SH OPCO, LLC | 1500 Waters Ridge Drive, Suite 200, Lewisville, TX 75057 |
| Street Address |
5721 S LEWIS AVE |
| City | TULSA |
| State | OK |
| Zip Code | 74105-7129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881208817 | Op Pharmacy LLC | Pharmacy | 2865 E. Skelly Dr., Ste 225, Tulsa, OK 74105 | 2020-09-08 |
| 1114560554 | Secure Interpretation, LLC | Neurological Surgery | 5561 South Lewis Ave, Tulsa, OK 74105 | 2019-10-17 |
| 1629547286 | Kealey Jordan Oliver | Occupational Therapist | 3223 E. 31st Steet, Tulsa, OK 74105 | 2018-11-13 |
| 1265915631 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 3516 S Peoria Ave, Tulsa, OK 74105 | 2018-09-12 |
| 1235635277 | Brenda Kay Sanders | Speech-Language Pathologist | 4911 S Detroit Ave, Tulsa, OK 74105 | 2018-03-30 |
| 1417400771 | Caroline Hunter Heineck | Speech-Language Pathologist | 3223 E. 31st St., Tulsa, OK 74105 | 2016-08-03 |
| 1437509544 | Reliance Care Health Services LLP | Home Health | 5810 S. Peoria Avenue, Tulsa, OK 74105 | 2016-06-20 |
| 1578921748 | Latisha Henderson | Case Manager/Care Coordinator | 3015 E. Skelly Drive, Suite 103, Tulsa, OK 74105 | 2016-02-03 |
| 1326424573 | Evelyn J Fennell | Nurse's Aide | 1143 E 57th Place, Tulsa, OK 74105 | 2015-08-10 |
| 1255717757 | Rebecca Ann Hughes | Dentist | 3150 E 41st St Ste 131, Tulsa, OK 74105 | 2015-08-06 |
| Find all providers in zip 74105 | ||||
| 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 |
|---|---|---|---|---|
| 1760748248 | Phoenix Rehab, LLC | Skilled Nursing Facility | 1021 Charles Page Blvd, Ste 200, Tulsa, OK 74127-8815 | 2012-04-09 |
| 1124226642 | Troy E Mcguire Jr. | Skilled Nursing Facility | 535 S Richmond Ave, Tulsa, OK 74112-4136 | 2007-07-05 |
| 1952444887 | Tulsa Christian Care Inc | Skilled Nursing Facility | 6201 E 36th St, Tulsa, OK 74135-5810 | 2007-02-14 |
| 1215013792 | Cox Retirement Properties Inc | Skilled Nursing Facility | 2552 E 21st St, Tulsa, OK 74114-1700 | 2006-10-27 |
| 1740296490 | Phoenix Healthcare LLC | Skilled Nursing Facility | 3601 N Columbia Ave, Tulsa, OK 74110-1232 | 2006-08-01 |
| 1104830421 | Phoenix Healthcare LLC | Skilled Nursing Facility | 1944 N Iroquois Ave, Tulsa, OK 74106-4407 | 2006-07-29 |
| 1700821493 | Oklahoma Methodist Manor Inc | Skilled Nursing Facility | 4134 E 31st St, Tulsa, OK 74135-1511 | 2006-06-18 |
| 1013958974 | Four Seasons Nursing Centers Inc | Skilled Nursing Facility | 2425 S Memorial Dr, Tulsa, OK 74129-2617 | 2006-06-09 |
| 1992750285 | Peak Medical Oklahoma No. 5, Inc. | Skilled Nursing Facility | 7707 S Memorial Dr, Tulsa, OK 74133-3643 | 2006-05-24 |
| 1497723621 | Cpc-sherwood Manor, Inc. | Skilled Nursing Facility | 2416 W 51st St, Tulsa, OK 74107-7700 | 2006-03-14 |
| Find all providers in TULSA | ||||
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| 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.