NPIMap

Organization Active NPI

State of Oklahoma

  • Skilled Nursing Facility
  • Clinton, OK
National Provider Identifier
1225295710
Registry record updated May 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
WVC2007003 Issued in OK
Legal business name
STATE OF OKLAHOMA
Practice address
1701 South 4TH
Clinton, OK 73601-1209
Phone
(580) 331-2200
Fax
(580) 323-4834
NPI assigned
May 21, 2008
Organization subpart
Yes
Parent organization
STATE OF OKLAHOMA/ OK DEPT VETERANSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 15, 2018

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

Authorized official

Name
Ms. Ermie Clinhna Williams, RN, CLNC, LNHA
Title
Compliance Director
Phone
(405) 523-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X WVC2007003 OK Primary

Addresses

Primary practice location

1701 South 4TH
Clinton, OK 73601-1209

Mailing address

PO Box 1209
Clinton, OK 73601-1209
Phone (580) 331-2200

Other names 1

  • Oklahoma Department of Veterans Affairs Other name

National Provider Directory

National Provider Directory
Tax ID family
Carl Albert Comm Ment H141 organizations share this tax ID, including this one
Part of
Carl Albert Comm Ment H

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1701 S 4th St
Clinton, OK 73601
Phone (580) 331-2200

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526342400000",
    "number": "1225295710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1209",
            "city": "CLINTON",
            "state": "OK",
            "postal_code": "736011209",
            "telephone_number": "580-331-2200",
            "fax_number": "580-323-4834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 SOUTH 4TH",
            "city": "CLINTON",
            "state": "OK",
            "postal_code": "736011209",
            "telephone_number": "580-331-2200",
            "fax_number": "580-323-4834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF OKLAHOMA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF OKLAHOMA/ OK DEPT VETERANS",
        "enumeration_date": "2008-05-21",
        "last_updated": "2018-05-15",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "ERMIE",
        "authorized_official_middle_name": "CLINHNA",
        "authorized_official_title_or_position": "COMPLIANCE DIRECTOR",
        "authorized_official_telephone_number": "405-523-4000",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, CLNC, LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OK",
            "license": "WVC2007003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oklahoma Department of Veterans Affairs",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clinton, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; 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.