Walnut Grove Living Center, Inc.

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

NH6110-6110 Issued in OK

Legal business name

WALNUT GROVE LIVING CENTER, INC.

Practice address

1001 S George Nigh Expy
McAlester, OK 74501-7286

Phone

(918) 423-7373

Fax

(918) 423-7156

NPI assigned

Jul 7, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Peggy W. Bennett

Title

Administrator

Phone

(918) 423-7373

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1013914779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3303",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745023303",
            "telephone_number": "918-423-7373",
            "fax_number": "918-423-7156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S GEORGE NIGH EXPY",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745017286",
            "telephone_number": "918-423-7373",
            "fax_number": "918-423-7156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALNUT GROVE LIVING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "918-423-7373",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "OK",
            "license": "NH6110-6110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100776710A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Iris Jenell Walla, R.N.
• Jennifer J Wallace, COTA/L
• Lauren Wallace, PA-C
• Donald Waller Jr., CMT
• Walnut Grove Living Center
• Walnut Healthcare, LLC
• Brenda L Walters Polansky, MED/LPC
• Katie Walters, BHRS
• Valarie Frances Walton
• Ward Hearing LLC

• Nursing Facility/Intermediate Care Facility in McAlester, OK
• Providers in McAlester, OK by specialty
• Nursing Facility/Intermediate Care Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.