NPIMap

Organization Active NPI

Brookwood Nursing Center, LLC

  • Skilled Nursing Facility
  • Oklahoma City, OK
National Provider Identifier
1295830933
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH5554-5554 Issued in OK
Legal business name
BROOKWOOD NURSING CENTER, LLC
Practice address
940 SW 84TH St
Oklahoma City, OK 73139-9255
Phone
(405) 636-0626
Fax
(405) 634-7738
NPI assigned
Sep 14, 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
Mike Dimond
Title
Manager
Phone
(405) 943-1144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH5554-5554 OK Primary

Addresses

Primary practice location

940 SW 84TH St
Oklahoma City, OK 73139-9255

Mailing address

940 SW 84TH St
Oklahoma City, OK 73139-9255
Phone (405) 636-0626

Other identifiers 1

IdentifierTypeStateIssuer
100776930AMedicaidOK

Other names 2

  • Brookwood Skilled Nursing and Therapy Doing business as
  • GRACE LIVING CENTER - BROOKWOOD Doing business as

Electronic endpoints 1

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030320000036 OK Part A Provider - Skilled Nursing Facility 9931018108 Practice locations: Oklahoma City, OK

Skilled nursing facility certification: CCN 375106

Legal name
BROOKWOOD NURSING CENTER LLC
Doing business as
BROOKWOOD SKILLED NURSING & THERAPY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 30, 1990
Last certification
May 7, 2024
Beds
137
Ownership / control type
Corporation
Organization structure
LLCProprietary
Enrollment address
940 SW 84TH St
Oklahoma City, OK 73139-9255
Nursing home name
BROOKWOOD SKILLED NURSING AND THERAPY
Affiliated entity
BRIDGES HEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
Brookwood Skilled Nursing and TherapyCCN 375106
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
May 30, 1990
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
137116.6 residents per day on average
Chain
Bridges Health33 facilities in the chain
Penalties (3 years)
4Fines totaling $39,328

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
37D0471695Brookwood Skilled Nursing and Therapy940 SW 84TH, Oklahoma City, OK 73139Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

1401 N Garland Rd
Enid, OK 73703
Phone (580) 234-2526

940 SW 84th St
Oklahoma City, OK 73139
Phone (405) 636-0261

5721 NW 132nd St
Oklahoma City, OK 73142
Phone (405) 557-1200

Ownership & related parties

All disclosed owners & managing parties 11

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 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%
FLP, L.L.C. Organization, Oklahoma City, OK LLC Adp of the SNF Jul 16, 2025
Bridges Employee Stock Ownership Trust Organization, Lisle, IL Created for acquisition 5% Or Greater Indirect Ownership Interest Dec 31, 2020 100%
Corey D Finch Individual Adp of the SNF Apr 15, 2025
William Brett Coble Individual Corporate DirectorManager Jan 1, 2021 100%
Joshua Wood Individual Managing Control - Governing BodyRegional Manager Jan 13, 2025
Adp of the SNF Jan 13, 2025
Amity Care, LLC Organization, Oklahoma City, OK LLC, Chain home office Operational/Managerial Control Jan 1, 2021
Adp of the SNF Nov 20, 2025
Londell Taylor Individual Operational/Managerial Control Mar 5, 2025
Managing Control - Governing BodyAdministrator Mar 5, 2025
Adp of the SNF Mar 5, 2025
Dennis Long Individual Operational/Managerial Control Jan 1, 2021
Robert Duncan Individual Adp of the SNF Dec 31, 2022

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 5

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": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760400000000",
    "number": "1295830933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 SW 84TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731399255",
            "telephone_number": "405-636-0626",
            "fax_number": "405-634-7738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 SW 84TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731399255",
            "telephone_number": "405-636-0626",
            "fax_number": "405-634-7738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKWOOD NURSING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "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": "NH5554-5554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100776930A",
            "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 Inc",
            "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": "Brookwood Skilled Nursing and Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GRACE LIVING CENTER - BROOKWOOD",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GRACE LIVING CENTER - BROOKWOOD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.