Organization Active NPI

Marlow Nursing & Rehabilitation LLC

Doing business as Marlow Nursing & Rehab

  • Nursing Facility/Intermediate Care Facility
  • Marlow, OK
National Provider Identifier
1346750817
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
NH6907 Issued in OK
Legal business name
MARLOW NURSING & REHABILITATION LLC
Doing business as
Marlow Nursing & Rehab
Practice address
702 S 9TH St
Marlow, OK 73055-3226
Phone
(580) 658-5468
Fax
(580) 658-3669
NPI assigned
Oct 10, 2017
Last updated
Jun 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X NH6907 OK Primary

Addresses

Primary practice location

702 S 9TH St
Marlow, OK 73055-3226

Mailing address

9 Professional Dr
Bella Vista, AR 72715-8462
Phone (479) 715-6759

Other names 1

  • Marlow Nursing & Rehab Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180116001926 OK Part A Provider - Skilled Nursing Facility 3476812686 Practice locations: Marlow, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346750817. Details of each certification follow.

Skilled nursing facility certification: CCN 375490

Legal name
MARLOW NURSING & REHABILITATION LLC
Doing business as
MARLOW NURSING & REHAB
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 12, 2005
Last certification
Jun 28, 2024
Beds
69
Ownership / control type
Individual
Organization structure
LLCProprietary
Incorporated
May 8, 2017 in OK
Enrollment address
702 S 9TH St
Marlow, OK 73055-3226
Nursing home name
MARLOW NURSING & REHAB
Affiliated entity
BRADFORD MONTGOMERY

Care Compare: Nursing home

Medicare Care Compare
Listed as
Marlow Nursing & RehabCCN 375490 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Individual
Certified
Aug 12, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6951.4 residents per day on average
Chain
Bradford Montgomery11 facilities in the chain

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
37D1040272Marlow Nursing and Rehab702 S 9TH St, Marlow, OK 73055Certificate of waiverMay 4, 2027

National Provider Directory

National Provider Directory

Ownership & 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.

NameRoleSinceShare
Bradford Montgomery Individual 5% Or Greater Direct Ownership InterestAuthorized Offical May 8, 2017 100%
Diana McMiller Individual W-2 Managing EmployeeAdministrator Dec 5, 2022 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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717718400000",
    "number": "1346750817",
    "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": "702 S 9TH ST",
            "city": "MARLOW",
            "state": "OK",
            "postal_code": "730553226",
            "telephone_number": "580-658-5468",
            "fax_number": "580-658-3669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARLOW NURSING & REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-10",
        "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": "Marlow Nursing & Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marlow, OK

Sources for this page

Verify at the official NPI Registry.