NPIMap

Organization Active NPI

Carter Healthcare of South Oklahoma, LLC

  • Home Health Agency
  • Ardmore, OK
National Provider Identifier
1346359411
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
7777 Issued in OK
Legal business name
CARTER HEALTHCARE OF SOUTH OKLAHOMA, LLC
Practice address
1052 Northwest Blvd
Ardmore, OK 73401-1533
Phone
(580) 226-3166
Fax
(580) 226-5901
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Justin Carter
Title
Authorized Official/President
Phone
(405) 947-7700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 7777 OK Primary

Addresses

Primary practice location

1052 Northwest Blvd
Ardmore, OK 73401-1533

Mailing address

7725 W Reno Ave Ste 332
Oklahoma City, OK 73127-9799
Phone (405) 947-7700

Other identifiers 1

IdentifierTypeStateIssuer
100261610DMedicaidOK

Other names 1

  • Carter Healthcare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161028000143 OK Part A Provider - Home Health Agency 7113205048 Practice locations: Ardmore, OK

Home health agency certification: CCN 377676

Legal name
CARTER HEALTHCARE OF SOUTH OKLAHOMA LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 26, 2004
Last certification
Jan 24, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Dec 1, 2015 in OK
Enrollment address
1052 Northwest Blvd
Ardmore, OK 73401-1533

Care Compare: Home health agency

Medicare Care Compare
Listed as
Carter Healthcare of South Oklahoma, LLCCCN 377676
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Aug 26, 2004
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Physical therapy

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
37D1026418Carter Healthcare of South Oklahoma, LLC1052 Northwest Blvd, Ardmore, OK 73401Certificate of waiverJun 3, 2028

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1052 Northwest Blvd
Ardmore, OK 73401
Phone (580) 226-3166

217 N Commerce St
Ste G
Ardmore, OK 73401
Phone (580) 226-3166

2013 Jaycee Ln
Clinton, OK 73601

5366 NW Cache Rd
Ste 2
Lawton, OK 73505
Phone (580) 353-0377

2846 E 101st St
Tulsa, OK 74137
Phone (918) 425-4000

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Carter Healthcare of Southwest Oklahoma, LLC Organization, Oklahoma City, OK LLC 5% Or Greater Direct Ownership Interest Nov 1, 2016 100%
Cynthia Carter Individual 5% Or Greater Indirect Ownership InterestBoard Member Sep 26, 2022 9.71%
Justin Carter Individual 5% Or Greater Indirect Ownership InterestManagerial Sep 27, 2022 90.29%
Corporate OfficerManager/President Sep 27, 2022
W-2 Managing Employee Sep 27, 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 5

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

Change-of-ownership history 2

DateEventCounterparty
Nov 1, 2016 Change of OwnershipThis provider was the buyer Carter HealthcareCCN 377676, OK, NPI 1346359411
Nov 1, 2016 Change of OwnershipThis provider was the seller Carter Healthcare of South Oklahoma LLCCCN 377676, OK, NPI 1346359411

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751414400000",
    "number": "1346359411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7725 W RENO AVE STE 332",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731279799",
            "telephone_number": "405-947-7700",
            "fax_number": "405-947-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1052 NORTHWEST BLVD",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011533",
            "telephone_number": "580-226-3166",
            "fax_number": "580-226-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARTER HEALTHCARE OF SOUTH OKLAHOMA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL/PRESIDENT",
        "authorized_official_telephone_number": "405-947-7700"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OK",
            "license": "7777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100261610D",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carter Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ardmore, OK

Sources for this page

Verify at the official NPI Registry.