NPIMap

Organization Active NPI

Peak Medical Oklahoma No. 13, Inc.

Doing business as Colonial Park Care and Rehabilitation Center

  • Skilled Nursing Facility
  • Okemah, OK
National Provider Identifier
1184664898
Registry record updated Sep 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH54055405 Issued in OK
Legal business name
PEAK MEDICAL OKLAHOMA NO. 13, INC.
Doing business as
Colonial Park Care and Rehabilitation Center
Practice address
600 West Frontage Rd
Okemah, OK 74859
Phone
(918) 623-1936
Fax
(918) 623-1938
NPI assigned
Jun 8, 2006
Last updated
Sep 28, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
SUNBRIDGE HEALTHCARE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 28, 2009

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

Authorized official

Name
William A. Mathies
Title
President Director
Phone
(505) 821-3355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH54055405 OK Primary

Addresses

Primary practice location

600 West Frontage Rd
Okemah, OK 74859

Mailing address

101 Sun Ave NE
Compliance Department
Albuquerque, NM 87109-4373
Phone (505) 468-5604

Other identifiers 1

IdentifierTypeStateIssuer
100779110AMedicaidOK

Other names 1

  • Colonial Park Care and Rehabilitation Center Doing business as

National Provider Directory

National Provider Directory
Part of
Sunrise HLTH Care Corp

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254096000000",
    "number": "1184664898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SUN AVE NE",
            "address_2": "COMPLIANCE DEPARTMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094373",
            "telephone_number": "505-468-5604",
            "fax_number": "505-468-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 WEST FRONTAGE RD",
            "city": "OKEMAH",
            "state": "OK",
            "postal_code": "74859",
            "telephone_number": "918-623-1936",
            "fax_number": "918-623-1938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK MEDICAL OKLAHOMA NO. 13, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUNBRIDGE HEALTHCARE CORPORATION",
        "enumeration_date": "2006-06-08",
        "last_updated": "2009-09-28",
        "status": "A",
        "authorized_official_last_name": "MATHIES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT DIRECTOR",
        "authorized_official_telephone_number": "505-821-3355"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OK",
            "license": "NH54055405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100779110A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colonial Park Care and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Okemah, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2009; 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.