NPIMap

Organization Active NPI

Phoenix Healthcare LLC

Doing business as Grove Nursing Center

  • Nursing Facility/Intermediate Care Facility
  • Grove, OK
National Provider Identifier
1356454094
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
NH2106-2106 Issued in OK
Legal business name
PHOENIX HEALTHCARE LLC
Doing business as
Grove Nursing Center
Practice address
1503 Har-Ber Rd
Grove, OK 74344-3525
Phone
(918) 786-3223
Fax
(918) 786-2664
NPI assigned
Aug 16, 2006
Last updated
May 14, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
PHOENIX HEALTHCARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Authorized official

Name
Mr. Les Tallman
Title
Administrator
Phone
(918) 786-3223

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X NH2106-2106 OK Primary

Addresses

Primary practice location

1503 Har-Ber Rd
Grove, OK 74344-3525

Mailing address

1503 W Har-Ber Rd
Grove, OK 74344
Phone (918) 786-3223

Other identifiers 1

IdentifierTypeStateIssuer
200040930FMedicaidOK

Other names 1

  • Grove Nursing Center Doing business as

Electronic endpoints 1

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050513000387 TX Part A Provider - Skilled Nursing Facility 6507818242 Practice locations: Grove, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356454094. Details of each certification follow.

Skilled nursing facility certification: CCN 375366

Legal name
PHOENIX HEALTHCARE LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 1, 1999
Last certification
Jul 17, 2024
Beds
133
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Phoenix Healthcare LLC
Most recent change of ownership
Nov 1, 2004
Organization structure
LLCProprietary
Incorporated
Sep 29, 2004 in OK
Enrollment address
Grove Nursing Center
1503 W Har-Ber Rd
Grove, OK 74344-3525
Nursing home name
GROVE NURSING CENTER
Affiliated entity
PHOENIX HEALTHCARE

Other NPIs with the same Medicare PAC ID 5

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Grove Nursing CenterCCN 375366 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Mar 1, 1999
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
13355.9 residents per day on average
Chain
Phoenix Healthcare6 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Phoenix Healthcare LLC6 organizations share this tax ID, including this one
Part of
Phoenix Healthcare LLC

Other organizations with this tax ID 5

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

Ownership & related parties

All disclosed owners & managing parties 26

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

NameRoleSinceShare
Individual Adp of the SNF Nov 16, 2024
Individual Adp of the SNF Nov 1, 2005
Individual Adp of the SNF Oct 14, 2004
Midwest Land & Investment Company Organization, Tulsa, OK Corporation Adp of the SNF Nov 1, 2005
Individual Adp of the SNF Feb 6, 2023
Phoenix Rehab LLC Organization, Tulsa, OK LLC, Medical provider/supplier Operational/Managerial Control Sep 29, 2004
Jill Jolene Carbajal Individual Operational/Managerial Control Mar 1, 2018
Cathy Young Individual Operational/Managerial Control Apr 24, 2009
Adp of the SNF Apr 24, 2009
Individual Adp of the SNF Jan 1, 2023
Organization, Tulsa, OK LLC Adp of the SNF Jun 13, 2025
Individual Adp of the SNF Apr 1, 2025
Individual Adp of the SNF Sep 1, 2023
Individual Adp of the SNF Nov 1, 2005
Jamie Grimes Individual Operational/Managerial Control Aug 23, 2021
Adp of the SNF Jun 26, 2025
Shanna Floyd Individual Operational/Managerial Control Jun 14, 2010
Adp of the SNF Jun 14, 2010
Individual Adp of the SNF Nov 13, 2009
Phoenix Healthcare LLC Organization, Tulsa, OK Created for acquisition, LLC, Chain home office, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Sep 29, 2004 100%
Operational/Managerial Control Sep 29, 2004
Adp of the SNF Jun 27, 2025
Individual Adp of the SNF Nov 1, 2023
Individual Adp of the SNF Nov 7, 2022
Forvis Mazars LLP Organization, Springfield, MO Consulting firm Operational/Managerial Control Oct 14, 2004
Adp of the SNF Jun 20, 2025
Individual Adp of the SNF Oct 24, 2022
Individual Adp of the SNF Nov 1, 2005
Larry Cain Individual 5% Or Greater Direct Ownership InterestReceiver Sep 29, 2004 100%
Individual Adp of the SNF Nov 1, 2023
Individual Adp of the SNF Feb 16, 2024
Kyle J Schauf Individual Operational/Managerial Control May 1, 2021
Adp of the SNF Jun 26, 2025

Owners & managing parties with NPI records 7

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

  • Jill Jolene Carbajal, APRN, FNP-C
    • Family Nurse Practitioner
    • Grove, OK
    • NPI 1609756139

    Operational/Managerial Control

    CMS ownership
  • Phoenix Health Care LLC

    dba South Park East

    • Alzheimer Center (Dementia Center)
    • Oklahoma City, OK
    • NPI 1972518835

    5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control

    CMS ownership
  • Phoenix Health Care, LLC

    dba Southern Oaks

    • Skilled Nursing Facility
    • Pawnee, OK
    • NPI 1710992250

    5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control

    CMS ownership
  • Phoenix Healthcare LLC

    dba Green Country Care Center

    • Skilled Nursing Facility
    • Tulsa, OK
    • NPI 1740296490

    5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control

    CMS ownership
  • Phoenix Healthcare LLC

    dba The Gardens

    • Nursing Facility/Intermediate Care Facility
    • Sapulpa, OK
    • NPI 1780694711

    5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control

    CMS ownership
  • Phoenix Healthcare LLC

    dba The Lakes Care Center

    • Skilled Nursing Facility
    • Oklahoma City, OK
    • NPI 1891700761

    5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control

    CMS ownership
  • Kyle J Schauf, MD
    • Family Medicine Physician
    • Grove, OK
    • NPI 1265662092

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Green Country Care CenterTulsa, OK, CCN 375421 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Sep 29, 2004
Sep 29, 2004
Jul 23, 2025
The GardensSapulpa, OK, CCN 375408 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Sep 29, 2004
Sep 29, 2004
Jul 18, 2025
Phoenix Healthcare LLCPawnee, OK, CCN 375378 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Sep 29, 2004
Sep 29, 2004
Aug 26, 2025
The LakesOklahoma City, OK, CCN 375396 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)
Adp of the SNF		 Sep 29, 2004
Sep 29, 2004
Jul 10, 2025
South Park EastOklahoma City, OK, CCN 375452 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Sep 29, 2004
Sep 29, 2004
Jul 15, 2025

Owned or controlled facilities with NPI records 5

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

  • Phoenix Health Care LLC

    dba South Park East

    • Alzheimer Center (Dementia Center)
    • Oklahoma City, OK
    • NPI 1972518835

    5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control

    CMS ownership
  • Phoenix Health Care, LLC

    dba Southern Oaks

    • Skilled Nursing Facility
    • Pawnee, OK
    • NPI 1710992250

    5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control

    CMS ownership
  • Phoenix Healthcare LLC

    dba Green Country Care Center

    • Skilled Nursing Facility
    • Tulsa, OK
    • NPI 1740296490

    5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control

    CMS ownership
  • Phoenix Healthcare LLC

    dba The Gardens

    • Nursing Facility/Intermediate Care Facility
    • Sapulpa, OK
    • NPI 1780694711

    5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control

    CMS ownership
  • Phoenix Healthcare LLC

    dba The Lakes Care Center

    • Skilled Nursing Facility
    • Oklahoma City, OK
    • NPI 1891700761

    5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 87

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

View all 87

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.

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": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778716800000",
    "number": "1356454094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 W HAR-BER RD",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "74344",
            "telephone_number": "918-786-3223",
            "fax_number": "918-786-2664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 HAR-BER RD",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743443525",
            "telephone_number": "918-786-3223",
            "fax_number": "918-786-2664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HEALTHCARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHOENIX HEALTHCARE LLC",
        "enumeration_date": "2006-08-16",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A",
        "authorized_official_last_name": "TALLMAN",
        "authorized_official_first_name": "LES",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "918-786-3223",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "OK",
            "license": "NH2106-2106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200040930F",
            "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",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Grove Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grove, OK

Sources for this page

Verify at the official NPI Registry.