Active NPI
McAlester Nursing & Rehabilitation LLC
- Nursing Facility/Intermediate Care Facility
- McAlester, OK
National Provider Identifier
1265942635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- License
- NH6907
- Legal business name
- MCALESTER NURSING & REHABILITATION LLC
- Doing business as
- McAlester Nursing & Rehab
- Practice address
- 615 E Morris Ave
McAlester, OK 74501-3159 - Phone
- (918) 426-4010
- Fax
- (918) 426-4820
- NPI assigned
- Oct 11, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bradford Montgomery
- Title
- Managing Member
- Phone
- (479) 715-6759
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | NH6907 | OK | Primary |
Addresses
Primary practice location
615 E Morris Ave
McAlester, OK 74501-3159
Mailing address
9 Professional Dr
Bella Vista, AR 72715-8462
Phone (479) 715-6759
Other names 1
- McAlester Nursing & Rehab
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180206000127 | OK | Part A Provider - Skilled Nursing Facility | 6507126877 | Practice locations: McAlester, OK |
Skilled nursing facility certification: CCN 375487
- Legal name
- MCALESTER NURSING & REHABILITATION LLC
- Doing business as
- MCALESTER NURSING & REHAB
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Sep 10, 2005
- Last certification
- Jul 31, 2024
- Beds
- 63
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Interhealth
- Most recent change of ownership
- Oct 1, 2017
- Organization structure
- LLC
- Incorporated
- May 8, 2017 in OK
- Enrollment address
- 615 E Morris Ave
McAlester, OK 74501-3159 - Nursing home name
- MCALESTER NURSING & REHAB
- Affiliated entity
- BRADFORD MONTGOMERY
Care Compare: Nursing home
Medicare Care Compare- Listed as
- McAlester Nursing & Rehab
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Sep 10, 2005
- Medicare certification status
- Active
- Certified beds
- 63
- Chain
- Bradford Montgomery
- Penalties (3 years)
- 2
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 37D0670962 | McAlester Nursing & Rehabilitation, LLC | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 2
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Bradford Montgomery | 5% Or Greater Direct Ownership Interest | May 8, 2017 | 100% |
| Dana Sandmann | W-2 Managing Employee | Oct 1, 2017 | 100% |
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Shawnee, OK
- NPI 1760555130
-
- Family Medicine Physician
- Sand Springs, OK
- NPI 1982699096
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507680000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1717718400000",
"number": "1265942635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 PROFESSIONAL DR",
"city": "BELLA VISTA",
"state": "AR",
"postal_code": "727158462",
"telephone_number": "479-715-6759",
"fax_number": "479-715-6922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 E MORRIS AVE",
"city": "MCALESTER",
"state": "OK",
"postal_code": "745013159",
"telephone_number": "918-426-4010",
"fax_number": "918-426-4820"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MCALESTER NURSING & REHABILITATION LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-10-11",
"last_updated": "2024-06-07",
"certification_date": "2024-06-07",
"status": "A",
"authorized_official_last_name": "MONTGOMERY",
"authorized_official_first_name": "BRADFORD",
"authorized_official_title_or_position": "MANAGING MEMBER",
"authorized_official_telephone_number": "479-715-6759"
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "OK",
"license": "NH6907",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "McAlester Nursing & Rehab",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in McAlester, OK
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- McAlester Heart, PC
- McAlester Imaging Associates LLC
- McAlester Manor Inc
- McAlester Medical Services, LLC
- McAlester Pet Associates LLC
- McAlester Physician Management Services
- McAlester Public Schools
- McAlester Regional Dialysis Center, LLC
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.