Paddington Place, LLC

Primary specialty

Mental Illness Intermediate Care FacilityTaxonomy code 310500000X

Legal business name

PADDINGTON PLACE, LLC

Practice address

76 Rachel Street
Bixby, OK 74008

Phone

(918) 290-3401

Fax

(539) 302-9786

NPI assigned

Jun 8, 2020

Organization subpart

No

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

Authorized official

Name

Scott D Pilgrim

Title

Managing Member

Phone

(405) 285-8166

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Paddington Place Cottages 1-4 Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 37G170

Legal name

PADDINGTON PLACE COTTAGE I

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Jul 1, 2022

Last certification

May 28, 2025

Beds

16

Ownership / control type

Private (proprietary)

Facility address

76 West Rachel Street, Unit a
Bixby, OK 74008

Intermediate care facility for individuals with intellectual disabilities certification: CCN 37G173

Legal name

PADDINGTON PLACE COTTAGE II

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Nov 4, 2022

Last certification

Jan 29, 2025

Beds

16

Ownership / control type

Private (proprietary)

Facility address

76 West Rachel Street
Bixby, OK 74008

Intermediate care facility for individuals with intellectual disabilities certification: CCN 37G180

Legal name

PADDINGTON PLACE COTTAGE III

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Jul 30, 2024

Last certification

May 28, 2025

Beds

16

Ownership / control type

Private (proprietary)

Facility address

76 West Rachel Street, Unit C
Bixby, OK 74008

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brandon King, D.O.

  • Family Medicine Physician
  • Gore, OK
  • NPI 1609173038
  NPD (past)

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

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723680000000",
    "number": "1043834849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 990",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730830990",
            "telephone_number": "405-285-8166",
            "fax_number": "405-563-9447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 RACHEL STREET",
            "city": "BIXBY",
            "state": "OK",
            "postal_code": "74008",
            "telephone_number": "918-290-3401",
            "fax_number": "539-302-9786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PADDINGTON PLACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-08",
        "last_updated": "2024-08-15",
        "certification_date": "2020-06-08",
        "status": "A",
        "authorized_official_last_name": "PILGRIM",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "405-285-8166"
    },
    "taxonomies": [
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201013670A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201013680A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paddington Place Cottages 1-4",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erin Rose Norvell
• Okc Dental Health Associates, P.C.
• Steven D. Oliver, DDS
• Osu Center for Health Sciences
• Allison Kayla Owen, M.S. CF-SLP
• Tygran Pahlevanyan
• Ralph J Palmer, DPH
• Katrina Parker, MS
• Nicholas Dwayne Parker
• Andrea Parrado

• Mental Illness Intermediate Care Facility in Bixby, OK
• Providers in Bixby, OK by specialty
• Mental Illness Intermediate Care Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.