PHOENIX REHAB, LLC (NPI# 1760748248) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760748248 |
| Entity Type | Organization |
| Organization Name | PHOENIX REHAB, LLC |
| Practice Address |
1021 Charles Page Blvd Ste 200 Tulsa OK 74127-8815 |
| Mailing Address |
1021 Charles Page Blvd Ste 200 Tulsa OK 74127 |
| Practice Telephone | 9185855109 |
| Practice Fax Number | 9187433767 |
| Mailing Telephone | 9185855109 |
| Mailing Fax Number | 9187433767 |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2012-04-09 |
| Authorized Official Name | MR. LARRY CAIN (OWNER) |
| Authorized Official Telephone | 9185855109 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437332178 | Phoenix Rehab, LLC | Clinic/Center | 1600 Scottsville Rd, Suite 101, Bowling Green, KY 42104-3217 | 2007-12-17 |
| Street Address |
1021 CHARLES PAGE BLVD STE 200 |
| City | TULSA |
| State | OK |
| Zip Code | 74127-8815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366966699 | Tarell Lynell Earl | Case Manager/Care Coordinator | 602 N. 28th W. Pl., Tulsa, OK 74127 | 2017-07-28 |
| 1023538014 | Milton Dean IIi | Counselor | 1234 N Rosedale, Tulsa, OK 74127 | 2017-06-21 |
| 1740700988 | Lisa Lee Ann Gilliland | Case Manager/Care Coordinator | 2001 W Ute Pl, Tulsa, OK 74127 | 2017-06-20 |
| 1114456498 | Kevin Thomas Jackson | Counselor | 310 S 49th W Ave, Tulsa, OK 74127 | 2017-06-08 |
| 1427406180 | Byron Conrad Dixon Jr. | Case Manager/Care Coordinator | 551 N. 28th W. Ave., Tulsa, OK 74127 | 2016-06-02 |
| 1548621568 | Brandon Worth | Student in an Organized Health Care Education/Training Program | 717 S. Houston Ave., Suite 400, Tulsa, OK 74127 | 2016-03-18 |
| 1073987467 | Jo Lowe | Social Worker | 420 S. Lawton Ave. Apt 315, Tulsa, OK 74127 | 2015-11-23 |
| 1154718575 | William Hughes | Health Educator | 3101 W Edison, Tulsa, OK 74127 | 2015-04-23 |
| 1801289665 | Kristyn Janelle Zrenda | Student in an Organized Health Care Education/Training Program | 717 S. Houston Ave., Suite 400, Tulsa, OK 74127 | 2015-03-17 |
| 1831595719 | Mallory Yarbrough | Counselor | 3005 N 24th West Ave, Tulsa, OK 74127 | 2014-11-05 |
| Find all providers in zip 74127 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1831172857 | Skyline Heights Operating Co LLC | Skilled Nursing Facility | 6202 E 61st St, Tulsa, OK 74136-2119 | 2005-11-23 |
| 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.