NPIMap

Organization Active NPI

Ambassador Operations LLC

Doing business as Ambassador Manor Nursing Center

  • Skilled Nursing Facility
  • Oklahoma City, OK
National Provider Identifier
1225496706
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
AMBASSADOR OPERATIONS LLC
Doing business as
Ambassador Manor Nursing Center
The Ambassador Skilled Nursing and Therapy
Practice address
4350 Will Rogers Pkwy
Suite 300
Oklahoma City, OK 73108-1826
Phone
(405) 943-1144
Fax
(406) 639-2742
NPI assigned
Jan 29, 2016
Last updated
Oct 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Authorized official

Name
Mike Dimond
Title
Manager
Phone
(405) 943-1144

Specialties & licenses 1

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

Addresses

Primary practice location

4350 Will Rogers Pkwy
Suite 300
Oklahoma City, OK 73108-1826

Mailing address

1340 E 61St St
Tulsa, OK 74136-0605
Phone (918) 743-8978

Other names 2

  • Ambassador Manor Nursing Center Doing business as
  • The Ambassador Skilled Nursing and Therapy Doing business as

Electronic endpoints 1

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160804001919 OK Part A Provider - Skilled Nursing Facility 5698069227 Practice locations: Tulsa, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225496706. Details of each certification follow.

Skilled nursing facility certification: CCN 375168

Legal name
AMBASSADOR OPERATIONS LLC
Doing business as
THE AMBASSADOR SKILLED NURSING AND THERAPY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 1, 1994
Last certification
Oct 24, 2024
Beds
171
Ownership / control type
Partnership
Organization structure
LLCProprietary
Incorporated
Mar 1, 2016 in OK
Enrollment address
1340 E 61St St
Tulsa, OK 74136-0605
Nursing home name
AMBASSADOR MANOR NURSING CENTER
Affiliated entity
BRIDGES HEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
Ambassador Manor Nursing CenterCCN 375168 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
May 1, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
171128.1 residents per day on average
Chain
Bridges Health33 facilities in the chain
Penalties (3 years)
1Fines totaling $9,077

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D0673403Ambassador Skilled Nursing and Therapy the1340 E 61St St, Tulsa, OK 74136Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

1340 E 61st St
Tulsa, OK 74136
Phone (918) 743-8978

Ownership & related parties

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 Contracted Managing EmployeeDirector of Accounts Receivable Mar 1, 2016
Corporate DirectorDirector of Accounts Receivable Mar 1, 2016
W-2 Managing EmployeeDirector of Accounts Receivable Mar 1, 2016
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 OfficerPresident Dec 31, 2020
Operational/Managerial ControlPresident Dec 31, 2020

Facilities with the same owner 33

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

View all 33

Practitioners & affiliated clinicians

Practitioners 2

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.

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1454025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760400000000",
    "number": "1225496706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 E 61ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741360605",
            "telephone_number": "918-743-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 WILL ROGERS PKWY",
            "address_2": "SUITE 300",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731081826",
            "telephone_number": "405-943-1144",
            "fax_number": "406-639-2742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBASSADOR OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-29",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A",
        "authorized_official_last_name": "DIMOND",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "405-943-1144"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd SteB",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Ambassador Manor Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Ambassador Skilled Nursing and Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.