Beadles, Inc.
Organization Active NPI Nursing Facility/Intermediate Care Facility · Alva, OK
NPI 1205948338 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1205948338
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nursing Facility/Intermediate Care Facility 313M00000X
- License
- NH7601-7601 (OK)
- Legal business name
- BEADLES, INC.
- Practice address
- 916 Noble St
Alva, OK 73717-2852 - Phone
- (580) 327-1274
- Fax
- (580) 327-2937
- NPI assigned
- Aug 31, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Mary Ruth Hiett, LPN OK #L0010078
- Title
- Co-Owner
- Phone
- (580) 327-5309
Practitioners 3
-
Adam Jordan, DPH
-
Henry Dean Vaughan, D.O.
Affiliated clinicians 1
Medicare Care Compare: Nursing home
- Listed as
- Beadles Nursing Home
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★★☆☆ 3 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jul 28, 2008
- Medicare certification status
- Active
- Certified beds
- 74 · 44.2 residents per day on average
- Penalties (3 years)
- 2 · fines totaling $14,069
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 37D0669893 | Beadles Nursing Home | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Skilled nursing facility certification: CCN 375524
- Legal name
- BEADLES, INC.
- Doing business as
- BEADLES NURSING HOME
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 28, 2008
- Last certification
- Aug 9, 2024
- Beds
- 74
- Ownership / control type
- Corporation
- Organization structure
- Corporation · Proprietary
- Incorporated
- Aug 12, 1965 in OK
- Enrollment address
- 916 Noble St
Beadles Nursing Home
Alva, OK 73717-2852 - Nursing home name
- BEADLES NURSING HOME
All disclosed owners & managing parties 8
| Name | Role | Since | Share |
|---|---|---|---|
| |
Adp of the SNF | Jan 1, 2025 | |
| |
Adp of the SNF | Jul 17, 2025 | |
| Adam Jordan |
5% Or Greater Direct Ownership Interest |
Jun 29, 2012 | 16.67% |
| Operational/Managerial Control | Jan 1, 2025 | ||
| Adp of the SNF | Jan 1, 2025 | ||
| |
Adp of the SNF | Jan 1, 2025 | |
| Blake Jordan |
5% Or Greater Direct Ownership Interest | Jan 1, 2025 | 8.33% |
| Adp of the SNF | Jul 17, 2025 | ||
| Barbara J Hiett |
5% Or Greater Direct Ownership Interest |
Jan 1, 2025 | 33.33% |
| Adp of the SNF | Jan 1, 2025 | ||
| Dayna Jordan |
5% Or Greater Direct Ownership Interest | Jan 1, 2025 | 16.66% |
| Adp of the SNF | Jan 1, 2025 | ||
| Marietta S Lynch |
5% Or Greater Direct Ownership Interest | Jan 1, 2025 | 25% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080527000785 | OK | Part a Provider - Skilled Nursing Facility | 3870662265 | Practice locations: Alva, OK |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | NH7601-7601 | OK | Yes |
Addresses
Primary practice location
916 Noble St
Alva, OK 73717-2852
Mailing address
PO Box 728
Alva, OK 73717-0728
Phone (580) 327-1274
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100773610A | Medicaid | OK |
Other names
- Beadles Nursing Home
Other providers in Alva, OK
- Alva Hospital Authority
- Alva Hospital Authority
- Karmen Ann Andrews
- Michelle Baird
- Beadles Operations, LLC
- Brent Michael Bogdanovecz
- Angela Borders
- Cherry Lacreta Bowen
- Jeramie Bradford
- Kaytlin S Brown
All providers in Alva, OK · Nursing Facility/Intermediate Care Facility in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.