NPIMap

Organization Active NPI

Oak Grove Manor

  • Skilled Nursing Facility
  • Sallisaw, OK
National Provider Identifier
1114019197
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH4505-4505 Issued in OK
Legal business name
OAK GROVE MANOR
Practice address
210 East Choctaw Street
Sallisaw, OK 74955-0429
Phone
(918) 775-4439
Fax
(918) 775-9242
NPI assigned
Sep 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Kevin Douglas Moran
Title
Business Management
Phone
(918) 775-4439

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH4505-4505 OK Primary

Addresses

Primary practice location

210 East Choctaw Street
Sallisaw, OK 74955-0429

Mailing address

PO Box 429
Sallisaw, OK 74955-0429
Phone (918) 775-4439

National Provider Directory

National Provider Directory
Tax ID family
Oak View Health Services6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114019197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 429",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749550429",
            "telephone_number": "918-775-4439",
            "fax_number": "918-775-9242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 EAST CHOCTAW STREET",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749550429",
            "telephone_number": "918-775-4439",
            "fax_number": "918-775-9242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK GROVE MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MORAN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "BUSINESS MANAGEMENT",
        "authorized_official_telephone_number": "918-775-4439",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OK",
            "license": "NH4505-4505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sallisaw, OK

Sources for this page

  • 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.