Corn Heritage Village of Weatherford Inc
Organization Active NPI Nursing Facility/Intermediate Care Facility · Weatherford, OK
NPI 1306809884 · NPPES record last updated Jun 1, 2009
Key facts
- NPI
- 1306809884
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nursing Facility/Intermediate Care Facility 313M00000X
- License
- NH2002 (OK)
- Legal business name
- CORN HERITAGE VILLAGE OF WEATHERFORD INC
- Practice address
- 801 N Washington St
Weatherford, OK 73096-4032 - Phone
- (580) 772-3993
- Fax
- (580) 774-1032
- NPI assigned
- Apr 7, 2006
- Organization subpart
- No
Authorized official
- Name
- Martin Hall
- Title
- Executive Director
- Phone
- (580) 343-2295
Owners & managing parties with NPI records 2
-
Michael E Aaron, M.D.
Facilities with the same owner 138
Practitioners 2
-
Michael E Aaron, M.D.
-
John Marshall Huser IV, M.D.
Affiliated clinicians 3
-
Blake Allen Badgett, M.D.
-
John Marshall Huser IV, M.D.
-
Kerby Lamb, DO
Medicare Care Compare: Nursing home
- Listed as
- Corn Heritage Village and Rehab of Weatherford
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★★★☆☆ 3 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★☆☆☆☆ 1 of 5
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Church related
- Certified
- Jul 1, 2009
- Medicare certification status
- Active
- Certified beds
- 81 · 51.7 residents per day on average
- Penalties (3 years)
- 1 · fines totaling $9,113
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 37D1066767 | Corn Heritage Village of Weatherford | Certificate of waiver | Apr 1, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Skilled nursing facility certification: CCN 375530
- Legal name
- CORN HERITAGE VILLAGE OF WEATHERFORD INC
- Doing business as
- CORN HERITAGE VILLAGE AND REHAB OF WEATHERFORD
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 1, 2009
- Last certification
- Jan 23, 2025
- Beds
- 81
- Ownership / control type
- Church Related
- Multi-facility organization
- Corn Heritage Village
- Organization structure
- Corporation · Non-profit
- Incorporated
- Mar 6, 2009 in OK
- Enrollment address
- 801 N Washington
Weatherford, OK 73096-4032 - Nursing home name
- CORN HERITAGE VILLAGE AND REHAB OF WEATHERFORD
All disclosed owners & managing parties 20
| Name | Role | Since | Share |
|---|---|---|---|
| |
Adp of the SNF | Aug 1, 2023 | |
| Jonathan Peters |
Corporate Director |
Sep 30, 2019 | |
| Onshift Inc |
Operational/Managerial Control | Feb 1, 2025 | |
| Adp of the SNF | Jun 25, 2025 | ||
| Citizens Bank of Oklahoma |
Operational/Managerial Control | Jan 1, 2017 | |
| Adp of the SNF | Jun 25, 2025 | ||
| Legacy Bank |
Operational/Managerial Control | Jan 1, 2017 | |
| Adp of the SNF | Jun 25, 2025 | ||
| Marci Russell |
Corporate Director |
Jan 1, 2024 | |
| Dianna Waldrop |
Operational/Managerial Control | Jan 1, 2025 | |
| Bart Gossen |
Corporate Director |
Jan 1, 2024 | |
| Twomagnets LLC |
Operational/Managerial Control | Apr 8, 2022 | |
| Adp of the SNF | Jun 25, 2025 | ||
| Michael E Aaron |
Operational/Managerial Control | May 1, 2021 | |
| Adp of the SNF | May 12, 2025 | ||
| Melissa Morgan |
Operational/Managerial Control | Jan 1, 2025 | |
| Josh Sawatzky |
Operational/Managerial Control | Jan 1, 2025 | |
| Aegis Therapies, Inc. |
Operational/Managerial Control | Oct 22, 2020 | |
| Adp of the SNF | Jun 25, 2025 | ||
| Zachary Williams |
Operational/Managerial Control | Jan 1, 2025 | |
| Forvis Mazars LLP |
Operational/Managerial Control | Jan 17, 2002 | |
| Adp of the SNF | Jun 25, 2025 | ||
| Jennifer Riley |
Operational/Managerial Control | Jan 1, 2025 | |
| Sheriffdeen M Raji |
Operational/Managerial Control | Jun 30, 2014 | |
| Adp of the SNF | Jun 30, 2014 | ||
| Howard Bartel |
Corporate Officer |
Sep 1, 2013 | |
| Clair Redcay |
Corporate Officer |
Sep 27, 2021 | |
| |
Adp of the SNF | Sep 1, 2010 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090715000798 | OK | Part a Provider - Skilled Nursing Facility | 9032261425 | Practice locations: Weatherford, OK |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | NH2002 | OK | Yes |
Addresses
Primary practice location
801 N Washington St
Weatherford, OK 73096-4032
Mailing address
801 N Washington St
Weatherford, OK 73096-4032
Phone (580) 772-3993
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200076200A | Medicaid | OK |
Other providers in Weatherford, OK
- Connected Flow Chiropractic PLLC
- Consolidated Oilfield Rentals, Inc
- Douglas B Cook
- Rachel Elizabeth Cook
- Corn Heritage Vilage of Weatherford
- Morgan Brook Corona
- Veronica Joleen Craig
- Kristin Jenea Cudd
- Randy Glen Curry
- Kenneth Gail Daniel
All providers in Weatherford, OK · Nursing Facility/Intermediate Care Facility in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 1, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.