Wynnewood Nursing Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH2506-2506 Issued in OK

Legal business name

WYNNEWOOD NURSING CENTER LLC

Doing business as

Grace Living Center - Wynnewood

Practice address

810 E California St
Wynnewood, OK 73098-3207

Phone

(405) 665-2330

Fax

(405) 665-4378

NPI assigned

Sep 14, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mike Dimond

Title

Manager

Phone

(405) 943-1144

Specialties & licenses 1

Addresses

Other names 1

• GRACE LIVING CENTER - WYNNEWOOD Doing business as

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063517704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 E CALIFORNIA ST",
            "city": "WYNNEWOOD",
            "state": "OK",
            "postal_code": "730983207",
            "telephone_number": "405-665-2330",
            "fax_number": "405-665-4378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 E CALIFORNIA ST",
            "city": "WYNNEWOOD",
            "state": "OK",
            "postal_code": "730983207",
            "telephone_number": "405-665-2330",
            "fax_number": "405-665-4378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYNNEWOOD NURSING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIMOND",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "405-943-1144"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OK",
            "license": "NH2506-2506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRACE LIVING CENTER - WYNNEWOOD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paige Juhree Theissen, P.A,-C
• William Wesley Webber, RPH
• Heather Wesberry
• Sharon D. Wheeler, R.D./L.D.
• Alisha Jo Whitebird, DNP, APRN, FNP-C
• Wynnewood Public Schools
• Wynnewood Urgent Care and Immediate Care Center PC
• Wynnewood Wellness Clinic

• Skilled Nursing Facility in Wynnewood, OK
• Providers in Wynnewood, OK by specialty
• Skilled Nursing Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.