Henryetta Community Skilled Healthcare and Rehab LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH5602 Issued in OK

Legal business name

HENRYETTA COMMUNITY SKILLED HEALTHCARE AND REHAB LLC

Doing business as

Henryetta Community Skilled Healthcare and Rehab

Practice address

212 North Antes
Henryetta, OK 74437

Phone

(918) 652-8797

Fax

(918) 652-0266

NPI assigned

Jun 14, 2016

Last updated

Sep 19, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Donna Simmons

Title

Managing Member

Phone

(405) 380-6671

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• Henryetta Community Skilled Healthcare and Rehab Doing business as
• Henryetta Community Skilled Healthcare & Rehab, LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376993071. Details of each certification follow.

• CCN 375569 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 375569

Legal name

HENRYETTA COMMUNITY SKILLED HEALTHCARE AND REHAB LLC

Doing business as

HENRYETTA COMMUNITY SKILLED HEALTHCARE & REHAB

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Nov 28, 2016

Last certification

May 8, 2025

Beds

53

Ownership / control type

Corporation

Multi-facility organization

Adkins Enterprises

Organization structure

LLCProprietary

Incorporated

Sep 9, 2015 in OK

Enrollment address

212 N Antes Ave
Henryetta, OK 74437-7331

Nursing home name

HEARTWAY AT HENRYETTA HEALTH AND REHAB

Listed as

Heartway at Henryetta Health and RehabCCN 375569 · All quality measures

Overall star rating

4 of 5

Health inspections

5 of 5

Staffing

4 of 5

Quality measures

1 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Nov 28, 2016

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

5333.4 residents per day on average

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 7

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

Practitioners 1

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.

• Angela Marie McGuire, D.O.

  • General Practice Physician
  • Oklahoma City, OK
  • NPI 1053492256
  NPD (past)

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1376993071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 N ANTES AVE",
            "city": "HENRYETTA",
            "state": "OK",
            "postal_code": "744377331",
            "telephone_number": "918-652-8797",
            "fax_number": "918-652-0266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 NORTH ANTES",
            "city": "HENRYETTA",
            "state": "OK",
            "postal_code": "74437",
            "telephone_number": "918-652-8797",
            "fax_number": "918-652-0266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRYETTA COMMUNITY SKILLED HEALTHCARE AND REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-14",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "405-380-6671"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OK",
            "license": "NH5602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200662260A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henryetta Community Skilled Healthcare and Rehab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Henryetta Community Skilled Healthcare and Rehab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Henryetta Community Skilled Healthcare & Rehab, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Angela Dawn Harris, MSW, LCSW
• Alaina Hayes
• Benjamin Hayes
• Rebecca Kaye Haynes, FNP-C
• HC SNF Ops LLC (Heartway at Henryetta Health and Rehab)
• Henryetta Dental Center
• Henryetta Drug LLC (Henryetta Drug)
• Henryetta Eye Center
• Henryetta Public Schools
• Henyretta Dental Center 2, PLLC

• Skilled Nursing Facility in Henryetta, OK
• Providers in Henryetta, OK by specialty
• Skilled Nursing Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (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.