PHOENIX HEALTH CARE, LLC (NPI# 1710992250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710992250 |
| Entity Type | Organization |
| Organization Name | PHOENIX HEALTH CARE, LLC |
| Other Organization Name | SOUTHERN OAKS |
| Practice Address |
1401 4th St Pawnee OK 74058-5003 |
| Practice Telephone | 9187622515 |
| Practice Fax Number | 9187623704 |
| Mailing Telephone | 9187622515 |
| Mailing Fax Number | 9187623704 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2008-08-11 |
| Authorized Official Name | MRS. SUSAN A. FONDREN (ADMINISTRATOR) |
| Authorized Official Telephone | 9187622515 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | NH5902-5902 | OK | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200040930E | 05 |
| Other Name | Type Code |
|---|---|
| Southern Oaks | Doing Business As Name - Organization |
| Street Address |
1401 4TH ST |
| City | PAWNEE |
| State | OK |
| Zip Code | 74058-5003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538709365 | Krista L Bright | Physical Therapy Assistant | 1401 4th St, Pawnee, OK 74058-5003 | 2020-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316214430 | Tonya L Houston | Nurse Practitioner | Pawnee Indian Health Center, 1201 Heritage Cir, Pawnee, OK 74058 | 2011-11-17 |
| 1659662153 | Christie Factor | Counselor | 540 Illinois, Pawnee, OK 74058 | 2011-05-02 |
| 1366476368 | Henry J Kaehler Jr Dds PC | Clinic/Center | 401 Forest St, Pawnee, OK 74058 | 2006-07-10 |
| 1003892621 | Brady Gene Englestead | Pediatrics | 1201 Heritage Circle, Pawnee, OK 74058 | 2005-12-15 |
| 1598039620 | Cah Acquisition Company 12 LLC | Clinic/Center | 535 6th St, Pawnee, OK 74058 | 2012-03-07 |
| 1639453665 | Creoks Mental Health Services | Community/Behavioral Health | 540 Illinois St, Pawnee, OK 74058 | 2011-10-10 |
| 1659473080 | Henry John Kaehler Jr. | Dentist | 401 Forest St, Pawnee, OK 74058 | 2006-09-05 |
| 1578503611 | William Lester Carruth | Dentist | 481 Agency Road, Pawnee, OK 74058-0130 | 2006-06-07 |
| 1821275744 | Patsy Ann Cooper | Counselor | 540 Illinois St, Pawnee, OK 74058-2036 | 2008-01-22 |
| 1225158314 | Cockrell Eyecare Center | Optometrist | 534 Illinois St, Pawnee, OK 74058-2036 | 2007-03-30 |
| Find all providers in zip 74058 | ||||
| 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 |
|---|---|---|---|---|
| 1861960940 | Memory Care Center At Emerald, LLC | Skilled Nursing Facility | 2700 Hickory St, Claremore, OK 74017-1214 | 2018-11-07 |
| 1689126138 | Cherish Life Services | Skilled Nursing Facility | 1110 E 4th Ave, Stillwater, OK 74074-3808 | 2016-11-01 |
| 1124574876 | Christine J Hurd | Skilled Nursing Facility | 1401 North Lelia Street, Guymon, OK 73942 | 2016-08-31 |
| 1376993071 | Henryetta Community Skilled Healthcare and Rehab, LLC | Skilled Nursing Facility | 212 N Antes Ave, Henryetta, OK 74437-7331 | 2016-06-14 |
| 1215382734 | Ok4 Ft. Gibson Opco LLC | Skilled Nursing Facility | 205 E Poplar St, Fort Gibson, OK 74434-8272 | 2016-05-03 |
| 1689029266 | Swalk Operations, LLC | Skilled Nursing Facility | 315 Sw 80th Street, Oklahoma City, OK 73139 | 2016-05-02 |
| 1255702791 | Tidwell Family Healthcare, LLC | Skilled Nursing Facility | 1209 W Main St, Quinton, OK 74561 | 2015-10-09 |
| 1033586664 | Colonial Park Manor, LLC | Skilled Nursing Facility | 600 W. Frontage Road, Okemah, OK 74859-6433 | 2015-08-31 |
| 1770963092 | Binger Nursing and Rehabilitation, LLC | Skilled Nursing Facility | 516 North Broadway, Binger, OK 73009-5002 | 2015-06-02 |
| 1467843177 | Summers Health Services, LLC | Skilled Nursing Facility | 119 N. 6th St, Okeene, OK 73763 | 2015-02-17 |
| Find all providers with the same taxonomy | ||||
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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.