Baptist Village Retirement Communities of Oklahoma, Inc.

Key facts

NPI: 1316934672
Entity type: Organization (NPI type 2)
Primary specialty: Skilled Nursing Facility 314000000X
License: CC7206-7206 (OK)
Legal business name: BAPTIST VILLAGE RETIREMENT COMMUNITIES OF OKLAHOMA, INC.
Practice address: 12600 E 73Rd St N
Owasso, OK 74055-4017
Phone: (918) 272-2281
Fax: (918) 272-7520
NPI assigned: Oct 3, 2005
Organization subpart: No

Authorized official

Name: Mr. Wendell Short
Title: VP Planning & Project Management
Phone: (405) 942-3800

Owners & managing parties with NPI records 4

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

Baptist Village Retirement Communities of Oklahoma Inc Nursing Facility/Intermediate Care Facility · Oklahoma City, OK · NPI 1447253240

CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST · ADP OF THE SNF · OPERATIONAL/MANAGERIAL CONTROL
Baptist Village Retirement Communities of Oklahoma Inc Skilled Nursing Facility · Enid, OK · NPI 1548037641

CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST · ADP OF THE SNF · OPERATIONAL/MANAGERIAL CONTROL
Baptist Village Retirement Communities of Oklahoma, Inc Durable Medical Equipment & Medical Supplies · Owasso, OK · NPI 1386625390

CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST · ADP OF THE SNF · OPERATIONAL/MANAGERIAL CONTROL
Brian Henry Lewis, DO Family Medicine Physician · Jenks, OK · NPI 1588748339

CMS ownership ADP OF THE SNF

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Baptist Village Retirement Communities of Oklahoma Inc Nursing Facility/Intermediate Care Facility · Oklahoma City, OK · NPI 1447253240

CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST · ADP OF THE SNF · OPERATIONAL/MANAGERIAL CONTROL
Baptist Village Retirement Communities of Oklahoma Inc Skilled Nursing Facility · Enid, OK · NPI 1548037641

CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST · ADP OF THE SNF · OPERATIONAL/MANAGERIAL CONTROL

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Baptist Village Retirement Communities of Oklahoma Inc Nursing Facility/Intermediate Care Facility · Oklahoma City, OK · NPI 1447253240

Same PAC ID 6204871106
Baptist Village Retirement Communities of Oklahoma Inc Skilled Nursing Facility · Enid, OK · NPI 1548037641

Same PAC ID 6204871106
Baptist Village Retirement Communities of Oklahoma, Inc Durable Medical Equipment & Medical Supplies · Owasso, OK · NPI 1386625390

Same PAC ID 6204871106

Corporate family (same tax ID) 7

Organizations that report the same tax identification number in the National Provider Directory.

Baptist Village Retirement Communities of Ok, Inc Home Health Agency · Oklahoma City, OK · NPI 1053369090

NPD tax ID
Baptist Village Retirement Communities of Oklahoma Inc Nursing Facility/Intermediate Care Facility · Oklahoma City, OK · NPI 1447253240

NPD tax ID
Baptist Village Retirement Communities of Oklahoma Inc Home Health Agency · Enid, OK · NPI 1518910850

NPD tax ID
Baptist Village Retirement Communities of Oklahoma Inc Skilled Nursing Facility · Enid, OK · NPI 1548037641

NPD tax ID
Baptist Village Retirement Communities of Oklahoma, Inc Home Health Agency · Owasso, OK · NPI 1134177223

NPD tax ID
Baptist Village Retirement Communities of Oklahoma, Inc Durable Medical Equipment & Medical Supplies · Owasso, OK · NPI 1386625390

NPD tax ID
Baptist Village Retirement Communities of Oklahoma, Inc Home Health Agency · Lawton, OK · NPI 1851532188

NPD tax ID

Facilities with the same owner 2

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

Baptist Village Retirement Communities of Oklahoma Inc Nursing Facility/Intermediate Care Facility · Oklahoma City, OK · NPI 1447253240

CMS ownership BAPTIST VILLAGE RETIREMENT COMMUNITIES OF OKLAHOMA, INC
Baptist Village Retirement Communities of Oklahoma Inc Skilled Nursing Facility · Enid, OK · NPI 1548037641

CMS ownership BAPTIST VILLAGE RETIREMENT COMMUNITIES OF OKLAHOMA, INC

Practitioners 1

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

Andrew Driscoll Donnelly, MD Family Medicine Physician · Jenks, OK · NPI 1154394062

NPD (past)

Affiliated clinicians 1

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

Andrew Driscoll Donnelly, MD Family Medicine Physician · Jenks, OK · NPI 1154394062

Care Compare affiliation Nursing home

Medicare Care Compare: Nursing home

Listed as: Baptist Village of Owasso CCN 375382
Overall star rating: ★★★☆☆ 3 of 5
Health inspections: ★★★☆☆ 3 of 5
Staffing: ★★☆☆☆ 2 of 5
Quality measures: ★★★☆☆ 3 of 5
Type: Medicare and Medicaid
Ownership: Non profit - Corporation
Certified: May 9, 2000
Medicare certification status: Active (Provider of Services file)
Certified beds: 120 · 77.2 residents per day on average
Penalties (3 years): 2 · fines totaling $18,155

Source: Medicare Care Compare, processed Aug 1, 2026.

Medicare participation

Medicare fee-for-service enrollment: Enrolled in OK

Skilled nursing facility certification: CCN 375382

Legal name: BAPTIST VILLAGE RETIREMENT COMMUNITIES OF OKLAHOMA, INC
Doing business as: BAPTIST VILLAGE OF OWASSO
Certification status: Active
Provider type (POS): Nursing home – SNF/NF dual certification
Participating since: May 9, 2000
Last certification: Jul 24, 2024
Beds: 120
Ownership / control type: Nonprofit Corporation
Organization structure: Other · Proprietary
Incorporated: May 9, 2000 in OK
Enrollment address: 12600 E 73Rd St N
Owasso, OK 74055-4017
Nursing home name: BAPTIST VILLAGE OF OWASSO

All disclosed owners & managing parties 44

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
Mary Russell Individual	Corporate Officer Corporate Secretary	Nov 19, 2019
Jacqueline Mink Individual	Corporate Director	Nov 30, 2021
Jacqueline Mink Individual	Adp of the SNF	Nov 30, 2021
Organization · Pittsburgh, PA Medical staffing company	Adp of the SNF	Mar 27, 2025
Randall D McFarland Individual	Corporate Officer 2ND Vice Chair	Nov 19, 2024
	Corporate Director	Nov 28, 2023
	Adp of the SNF	Nov 28, 2023
Jean Barrett Individual	Corporate Director Advisor	Nov 28, 2023
Jean Barrett Individual	Adp of the SNF	Nov 28, 2023
Michael Johnson Individual	Corporate Director	Nov 19, 2024
Michael Johnson Individual	Adp of the SNF	Nov 19, 2024
Paul Abbott Individual	Corporate Director Advisor	Nov 18, 2025
Paul Abbott Individual	Adp of the SNF	Nov 18, 2025
Organization · Walnut, CA Medical staffing company	Adp of the SNF	Mar 27, 2025
Susan Rooker Individual	Corporate Officer Corporate Secretary	Nov 19, 2019
	Operational/Managerial Control	Nov 19, 2019
	Adp of the SNF	Nov 19, 2019
Doug Burrows Individual	Corporate Director	Nov 18, 2025
Doug Burrows Individual	Adp of the SNF	Nov 18, 2025
Steven Walkingstick Individual	Operational/Managerial Control	Jul 15, 2021
Steven Walkingstick Individual	Adp of the SNF	Jul 15, 2021
Margaret Smith Individual	Corporate Director	Nov 19, 2024
Margaret Smith Individual	Adp of the SNF	Nov 19, 2024
Linda Gibbs Individual	Corporate Director	Nov 30, 2021
Linda Gibbs Individual	Adp of the SNF	Nov 30, 2021
Linda Enlow Individual	Corporate Director	Nov 28, 2023
Linda Enlow Individual	Adp of the SNF	Nov 28, 2023
Parniece Briggs Individual	Corporate Director	Nov 18, 2025
Parniece Briggs Individual	Adp of the SNF	Nov 18, 2025
Samuel Staats Individual	Corporate Director	Nov 19, 2024
Samuel Staats Individual	Adp of the SNF	Nov 19, 2024
Todd Fisher Individual	Corporate Director	Nov 30, 2021
Todd Fisher Individual	Adp of the SNF	Nov 30, 2021
Mitzi Lynn Epperson Individual	Operational/Managerial Control	Jul 7, 2008
Mitzi Lynn Epperson Individual	Adp of the SNF	Jul 7, 2008
William M Pierce Individual	Corporate Officer President	Oct 1, 1993
	Operational/Managerial Control	Oct 1, 1993
	Adp of the SNF	Oct 1, 1993
Mark Gandy Individual	Corporate Officer Chair	Nov 19, 2024
	Corporate Director	Nov 30, 2021
	Adp of the SNF	Nov 30, 2021
George Gibbs Individual	Corporate Director Advisor	Nov 19, 2024
George Gibbs Individual	Adp of the SNF	Nov 19, 2024
Nan Haynes Individual	Corporate Director	Nov 18, 2025
Nan Haynes Individual	Adp of the SNF	Nov 18, 2025
Brian Koons Individual	Corporate Director	Nov 18, 2025
Brian Koons Individual	Adp of the SNF	Nov 18, 2025
Baptist Village Retirement Communities of Oklahoma, Inc Organization · Oklahoma City, OK Corporation, Non-profit	5% Or Greater Direct Ownership Interest	Sep 26, 1993	100%
	Operational/Managerial Control	Sep 26, 1993
	Adp of the SNF	Sep 26, 1993
Matthew Trentham Individual	Corporate Officer Vice Chair	Nov 19, 2024
	Corporate Director	Nov 28, 2023
	Adp of the SNF	Nov 28, 2023
Kerry Russell Individual	Corporate Director Advisor	Nov 19, 2024
Kerry Russell Individual	Adp of the SNF	Nov 19, 2024
Lauri Fluke Individual	Corporate Officer VP Finance/Cfo	Jun 1, 2021
	Operational/Managerial Control	Jun 1, 2021
	Adp of the SNF	Jun 1, 2013
Eddie Miller Individual	Corporate Director Advisor	Nov 19, 2024
Eddie Miller Individual	Adp of the SNF	Nov 19, 2024
Organization · Oklahoma City, OK Financial institution	Adp of the SNF	Mar 24, 2025
Michael Matlock Individual	Corporate Director	Nov 19, 2019
Michael Matlock Individual	Adp of the SNF	Nov 19, 2019
Judy Miles Individual	Corporate Director	Nov 28, 2023
Judy Miles Individual	Adp of the SNF	Nov 28, 2023
Catherine Netherland Goddard Individual	Corporate Director Advisor	Nov 19, 2024
Catherine Netherland Goddard Individual	Adp of the SNF	Nov 19, 2024
Organization · Fargo, ND	Adp of the SNF	Mar 24, 2025
Andy McPherson Individual	Corporate Director	Nov 18, 2025
Andy McPherson Individual	Adp of the SNF	Nov 18, 2025
Kellye Fuchs Individual	Corporate Director	Nov 28, 2023
Kellye Fuchs Individual	Adp of the SNF	Nov 28, 2023
Kevin Bell Individual	Corporate Director	Nov 17, 2020
Kevin Bell Individual	Adp of the SNF	Nov 17, 2020
Paul Scott Individual	Corporate Director	Nov 29, 2022
Paul Scott Individual	Adp of the SNF	Nov 29, 2022
Brian H Lewis Individual	Adp of the SNF	Apr 14, 2012
Wendell Short Individual	Corporate Officer VP of Planning & Project MGMT	Jun 1, 2013
	Operational/Managerial Control	Jun 1, 2013
	Adp of the SNF	Jun 1, 2013
Steven Thomas Individual	Corporate Officer	May 1, 2003
	Operational/Managerial Control	May 1, 2003
	Adp of the SNF	May 1, 2003
Frieda Stewart Individual	Corporate Officer VP Quality	Aug 20, 2019
	Operational/Managerial Control	Aug 20, 2019
	Adp of the SNF	Aug 20, 2019
Frank C Davis Individual	Corporate Director	Nov 29, 2022
Frank C Davis Individual	Adp of the SNF	Nov 29, 2022
James Turner Individual	Corporate Director	Nov 28, 2023
James Turner Individual	Adp of the SNF	Nov 28, 2023
Will Johnson Individual	Corporate Director	Nov 17, 2020
Will Johnson Individual	Adp of the SNF	Nov 17, 2020

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Facility	Type	Role	Since
TB Lackey Health Care Ctr Oklahoma City, OK · CCN 375381	Skilled nursing facility	5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF	Sep 26, 1993 Sep 26, 1993 Sep 26, 1993
Baptist Village of Enid Enid, OK · CCN 375406	Skilled nursing facility	5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF	Dec 1, 2023 Dec 1, 2023 Dec 1, 2023

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20060203000448	OK	Part a Provider - Skilled Nursing Facility	6204871106	Practice locations: Owasso, OK

National Provider Directory

Tax ID family: Baptist Village Retirement Communities of Ok Inc (8 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Skilled Nursing Facility	314000000X	CC7206-7206	OK	Yes

Addresses

Primary practice location

12600 E 73Rd St N
Owasso, OK 74055-4017

Mailing address

12600 E 73Rd St N
Owasso, OK 74055-4017
Phone (918) 272-2281

Other identifiers

Identifier	Type	State	Issuer
100810750B	Medicaid	OK

Other names

Baptist Village of Owasso Doing business as

Other providers in Owasso, OK

All providers in Owasso, OK · Skilled Nursing 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 Sep 11, 2025. 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.

Verify at the official NPI Registry.