Fountain View Manor, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

375462 Issued in OK

Legal business name

FOUNTAIN VIEW MANOR, INC

Practice address

107 E Barclay St
Henryetta, OK 74437-5609

Phone

(918) 652-7021

Fax

(918) 652-7216

NPI assigned

Jul 11, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer Michelle Clason, LPN, NHADM.

Title

Adm.

Phone

(918) 652-7021

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Skilled nursing facility certification: CCN 375462

Legal name

FOUNTAIN VIEW MANOR, INC.

Doing business as

FOUNTAIN VIEW MANOR

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Sep 30, 2003

Last certification

Apr 25, 2024

Beds

119

Ownership / control type

Corporation

Organization structure

CorporationProprietary

Incorporated

May 17, 1967 in OK

Enrollment address

107 East Barclay
PO Box 520
Henryetta, OK 74437-5609

Nursing home name

FOUNTAIN VIEW MANOR, INC

Listed as

Fountain View Manor, IncCCN 375462

Overall star rating

2 of 5

Health inspections

3 of 5

Staffing

2 of 5

Quality measures

1 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Sep 30, 2003

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

11981.7 residents per day on average

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Angela Marie McGuire, D.O.

  • General Practice Physician
  • Oklahoma City, OK
  • NPI 1053492256

  Adp of the SNF

  CMS ownership

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

• Angela Marie McGuire, D.O.

  • General Practice Physician
  • Oklahoma City, OK
  • NPI 1053492256
  NPD (past)

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Michael Terence Cain, D.O.

  • Family Medicine Physician
  • Henryetta, OK
  • NPI 1528001518

  Nursing home

  Care Compare affiliation
• Clayton Wayne Flanary, DO

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1740215680

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371686400000",
    "number": "1124026448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 E BARCLAY ST",
            "address_2": "P.O. BOX 520",
            "city": "HENRYETTA",
            "state": "OK",
            "postal_code": "744375609",
            "telephone_number": "918-652-7021",
            "fax_number": "918-652-7216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E BARCLAY ST",
            "city": "HENRYETTA",
            "state": "OK",
            "postal_code": "744375609",
            "telephone_number": "918-652-7021",
            "fax_number": "918-652-7216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN VIEW MANOR, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-11",
        "last_updated": "2013-06-20",
        "status": "A",
        "authorized_official_last_name": "CLASON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "ADM.",
        "authorized_official_telephone_number": "918-652-7021",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPN, NHADM."
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "OK",
            "license": "NH56035603",
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "OK",
            "license": "NH56035603",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OK",
            "license": "375462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100773730A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eidetik of Weleetka, LLC
• Eidetik of Weleetka, LLC
• Eidetik of Weleetka, LLC
• Eidetik of Weleetka. LLC
• Beau Barker Evans, D.D.S.
• Fresenius Medical Care Tulsa, LLC
• Gary Jay Lavalley, PC
• Green Hills Emergency Physicians LLC
• Jarrod Greiner, PT, DPT
• Penelope Griffin, PTA

• All providers in Henryetta, OK
• Skilled Nursing Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2013; 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.