NPIMap

Organization Active NPI

Timberlane Manor, LLC

  • Skilled Nursing Facility
  • Edmond, OK
National Provider Identifier
1255425898
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH5536-5536 Issued in OK
Legal business name
TIMBERLANE MANOR, LLC
Practice address
2520 South Rankin
Edmond, OK 73013
Phone
(405) 341-1433
Fax
(405) 562-2128
NPI assigned
Oct 3, 2006
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
Kristy Deroin, MBA
Title
Director of Reimbursement
Phone
(405) 943-1144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH5536-5536 OK Primary

Addresses

Primary practice location

2520 South Rankin
Edmond, OK 73013

Mailing address

2520 South Rankin
Edmond, OK 73013
Phone (405) 341-1433

Other identifiers 1

IdentifierTypeStateIssuer
100810270BMedicaidOK

Other names 2

  • GRACE LIVING CENTER - EDMOND Doing business as
  • The Timbers 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
O20200918000412 OK Part A Provider - Skilled Nursing Facility 1052220225 Practice locations: Edmond, OK

Skilled nursing facility certification: CCN 375158

Legal name
TIMBERLANE MANOR LLC
Doing business as
THE TIMBERS SKILLED NURSING AND THERAPY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 1, 1994
Last certification
Jun 20, 2024
Beds
129
Ownership / control type
Partnership
Organization structure
LLCProprietary
Enrollment address
2520 S Rankin St
Edmond, OK 73013-5213
Nursing home name
THE TIMBERS SKILLED NURSING AND THERAPY
Affiliated entity
BRIDGES HEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
The Timbers Skilled Nursing and TherapyCCN 375158
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
4 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
Apr 1, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
129118.4 residents per day on average
Chain
Bridges Health33 facilities in the chain
Penalties (3 years)
2Fines totaling $34,706

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
37D0469486Timbers Skilled Nursing and Therapy, the2520 S Rankin St, Edmond, OK 73013Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
John C Martin Individual Operational/Managerial Control Nov 1, 2018
Adp of the SNF Nov 1, 2018
Kristy Deroin Individual Corporate DirectorDirector of Revenue Cycle Jan 1, 2021
Adp of the SNF Jan 1, 2021
Bridges Esop, Inc Organization, Oklahoma City, OK Created for acquisition, Corporation, Owned by another organization or individual 5% Or Greater Direct Ownership Interest 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 Griffin Individual Corporate OfficerCoo Jan 1, 2021 100%
Adp of the SNF Jan 1, 2021
Michael a Boone Individual Managing Control - Governing BodyRegional Manager Jan 1, 2021
Adp of the SNF Jan 1, 2021
William Brett Coble Individual Corporate OfficerPresident Apr 1, 2020 100%
Adp of the SNF Jan 1, 2021
Russell Lanier Individual Adp of the SNF Jan 1, 2021
Amity Care, LLC Organization, Oklahoma City, OK LLC, Chain home office Adp of the SNF Nov 20, 2025
Dennis Long Individual Adp of the SNF Jan 1, 2021
Robert Duncan Individual Adp of the SNF Dec 13, 2022
Renew Properties, LLC Organization, Oklahoma City, OK LLC Adp of the SNF Mar 18, 2018
Kenneth D. Greiner III Revocable Trust Organization, Oklahoma City, OK 5% Or Greater Security Interest Dec 31, 2020 47.3%
Timwest, LLC Organization, Oklahoma City, OK LLC Adp of the SNF Nov 30, 1998

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

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 4

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

Affiliated clinicians 3

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": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760400000000",
    "number": "1255425898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 SOUTH RANKIN",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "73013",
            "telephone_number": "405-341-1433",
            "fax_number": "405-562-2128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 SOUTH RANKIN",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "73013",
            "telephone_number": "405-341-1433",
            "fax_number": "405-562-2128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMBERLANE MANOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A",
        "authorized_official_last_name": "DEROIN",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "405-943-1144",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OK",
            "license": "NH5536-5536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100810270B",
            "state": "OK"
        }
    ],
    "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",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "GRACE LIVING CENTER - EDMOND",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GRACE LIVING CENTER - EDMOND",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Timbers Skilled Nursing and Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.