Organization Active NPI

Oak Ridge Manor, Inc

  • Assisted Living Facility (Mental Illness)
  • Oak Ridge, MO
National Provider Identifier
1083743629
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X
License
033528 Issued in MO
Legal business name
OAK RIDGE MANOR, INC
Practice address
5108 State Highway B
Oak Ridge, MO 63769
Phone
(573) 266-0206
Fax
(573) 334-8145
NPI assigned
Mar 2, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Tomi Sample
Title
President
Phone
(573) 334-7679

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 033528 MO
Assisted Living Facility (Mental Illness) 3104A0625X 033528 MO Primary

Addresses

Primary practice location

5108 State Highway B
Oak Ridge, MO 63769

Mailing address

210 Franks LN
Cape Girardeau, MO 63701-8439
Phone (573) 334-7679

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1083743629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 FRANKS LN",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637018439",
            "telephone_number": "573-334-7679",
            "fax_number": "573-334-8145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5108 STATE HIGHWAY B",
            "city": "OAK RIDGE",
            "state": "MO",
            "postal_code": "63769",
            "telephone_number": "573-266-0206",
            "fax_number": "573-334-8145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK RIDGE MANOR, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "SAMPLE",
        "authorized_official_first_name": "TOMI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-334-7679"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MO",
            "license": "033528",
            "primary": false
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "MO",
            "license": "033528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.