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Sooner Geriatrics, LLC

Organization Active NPI Skilled Nursing Facility · Oklahoma City, OK

NPI 1164527727 · NPPES record last updated Feb 6, 2026

Key facts

NPI
1164527727
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
License
NH5501-5501 (OK)
Legal business name
SOONER GERIATRICS, LLC
Practice address
1913 NE 50TH St
Oklahoma City, OK 73111-7003
Phone
(405) 427-5414
Fax
(405) 427-5432
NPI assigned
Sep 14, 2006
Organization subpart
No

Authorized official

Name
Kristy Deroin
Title
Director of Reimbursement
Phone
(405) 943-1144

Facilities with the same owner 33

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 33

Practitioners 3

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

Affiliated clinicians 1

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

Medicare Care Compare: Nursing home

Listed as
Wildewood Skilled Nursing and Therapy CCN 375383
Overall star rating
★★★☆☆ 3 of 5
Health inspections
★★★☆☆ 3 of 5
Staffing
★★★★☆ 4 of 5
Quality measures
★★★☆☆ 3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
Feb 16, 2000
Medicare certification status
Active (Provider of Services file)
Certified beds
107 · 74.9 residents per day on average
Chain
Bridges Health (33 facilities)

Source: Medicare Care Compare, processed Aug 1, 2026.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D0871819Wildewood Skilled Nursing and Therapy
1913 NE 50TH, Oklahoma City, OK 73111		Certificate of waiverJun 6, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OK

Skilled nursing facility certification: CCN 375383

Legal name
SOONER GERIATRICS LLC
Doing business as
WILDEWOOD SKILLED NURSING AND THERAPY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 16, 2000
Last certification
Sep 16, 2024
Beds
107
Ownership / control type
Partnership
Most recent change of ownership
Jun 30, 2017
Organization structure
LLC · Proprietary
Enrollment address
1913 NE 50TH St
Oklahoma City, OK 73111-7003
Nursing home name
WILDEWOOD SKILLED NURSING AND THERAPY
Affiliated entity
BRIDGES HEALTH

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Kristy Deroin
Individual 		W-2 Managing Employee Apr 1, 2020
Bridges Esop, Inc
Organization · Oklahoma City, OK
Corporation 		5% Or Greater Direct Ownership Interest Dec 31, 2020 100%
Operational/Managerial Control Dec 31, 2020 100%
Bridges Employee Stock Ownership Trust
Organization · Lisle, IL
Created for acquisition 		5% Or Greater Indirect Ownership Interest Dec 31, 2020 100%
William Brett Coble
Individual 		Corporate Officer
President		 Apr 1, 2020
Operational/Managerial Control
President		 Apr 1, 2020

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200909003402 OK Part a Provider - Skilled Nursing Facility 9032028170 Practice locations: Oklahoma City, OK

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH5501-5501 OK Yes

Addresses

Primary practice location

1913 NE 50TH St
Oklahoma City, OK 73111-7003

Mailing address

1921 NE 50TH St
Oklahoma City, OK 73111-2420
Phone (405) 427-5414

Other identifiers

IdentifierTypeStateIssuer
100778040AMedicaidOK

Other names

  • GRACE LIVING CENTER - WILDEWOOD Doing business as
  • WILDEWOOD SKILLED NURSING AND THERAPY Doing business as
  • Sooner Geriatrics, LLC Former legal business name

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Other providers in Oklahoma City, OK

All providers in Oklahoma City, OK · Skilled Nursing Facility in Oklahoma

Sources for this page

Verify at the official NPI Registry.