SENIOR VILLAGE NURSING HOME (NPI# 1336132539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336132539 |
| Entity Type | Organization |
| Organization Name | SENIOR VILLAGE NURSING HOME |
| Practice Address |
1104 N Madison Ave Blanchard OK 73010-6504 |
| Practice Telephone | 4054853315 |
| Mailing Telephone | 4054853315 |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2008-07-01 |
| Authorized Official Name | MR. BOBBY VERNON SIMMONS (MANAGER) |
| Authorized Official Telephone | 4053602562 |
| Authorized Official Credential | D.PH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | NH4403-4403 | OK | Nursing & Custodial Care Facilities |
| Street Address |
1104 N MADISON AVE |
| City | BLANCHARD |
| State | OK |
| Zip Code | 73010-6504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538661905 | Senior Village Operations LLC | Skilled Nursing Facility | 1104 N Madison Ave, Blanchard, OK 73010-6504 | 2018-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609135862 | Stephanie Michelle Thomas | Speech-Language Pathologist | 2286 Cottage Lane, Blanchard, OK 73010 | 2012-05-09 |
| 1235382540 | Saints Medical Group, LLC | Family Medicine | 2002 N Council Ave, Blanchard, OK 73010 | 2008-10-30 |
| 1811154008 | Brant D. Spencer D.c. P.C. | Chiropractor | 104 S Main Street, Blanchard, OK 73010 | 2008-05-16 |
| 1932374675 | Travis L Turney Dds | Clinic/Center | 809 East Veterans Memorial Hwy, Blanchard, OK 73010 | 2008-04-24 |
| 1215134051 | Travis Lisle Turney | Dentist | 809 E Veterans Memorial Hwy, Blanchard, OK 73010 | 2007-06-27 |
| 1083735625 | Stephanie R Nesmith | Counselor | 27811 Portland Ave, Blanchard, OK 73010 | 2007-04-02 |
| 1588608376 | Ronald Keith Smith | Dentist | 1019 N. Council Ave, Suite # 2, Blanchard, OK 73010 | 2006-06-15 |
| 1659333557 | Brant D. Spencer | Chiropractor | 104 S. Main, Blanchard, OK 73010 | 2006-04-05 |
| 1376519397 | Vincent Michael Young | Optometrist | 112 S. Main, Blanchard, OK 73010 | 2006-02-28 |
| 1528693074 | Kaitlyn Nicole Boyce | Behavior Technician | 14828 Serenita Ave, Oklahoma City, OK 73010 | 2020-03-05 |
| Find all providers in zip 73010 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306455696 | Global Higher Call Nursing, LLC | Nursing Facility/Intermediate Care Facility | 407 Whitebird St, Quapaw, OK 74363-0912 | 2020-07-23 |
| 1336641786 | Sherri Geanette Hilburn | Nursing Facility/Intermediate Care Facility | 225 N. Broadway, Carnegie, OK 73015 | 2018-03-01 |
| 1750891149 | Anadarko Nursing & Rehabilitation LLC | Nursing Facility/Intermediate Care Facility | 300 West Washington, Anadarko, OK 73005 | 2017-10-11 |
| 1659773778 | First Choice Home Medical Inc | Nursing Facility/Intermediate Care Facility | 720 N Galena Ave, Geary, OK 73040-1501 | 2014-09-19 |
| 1467852244 | Jlg Healthcare LLC | Nursing Facility/Intermediate Care Facility | 811 W Elk, Duncan, OK 73533-1196 | 2014-08-28 |
| 1720326622 | Integris Rehab LLC | Nursing Facility/Intermediate Care Facility | 14145 S 220th East Ave, Coweta, OK 74429-6269 | 2013-01-28 |
| 1053617761 | Colonial Park Healthcare Center LLC | Nursing Facility/Intermediate Care Facility | 600 W Frontage Rd, Okemah, OK 74859-6433 | 2011-01-28 |
| 1851562136 | Thomas Health and Rehabilitation LLC | Nursing Facility/Intermediate Care Facility | 601 East Frisco Street, Thomas, OK 73669 | 2008-03-14 |
| 1770768566 | Cox Building Company, Inc. | Nursing Facility/Intermediate Care Facility | 3501 W Washington St, Broken Arrow, OK 74012-9196 | 2007-12-31 |
| 1477745834 | Rehabcare | Nursing Facility/Intermediate Care Facility | 300 Rockefeller, Muskogee, OK 74401-5235 | 2007-08-09 |
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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.