Teal Creek Life Care Community Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL5541 Issued in OK

Legal business name

TEAL CREEK LIFE CARE COMMUNITY INC

Practice address

13501 N. Bryant Ave.
Edmond, OK 73013

Phone

(405) 312-8050

Fax

(866) 542-6483

NPI assigned

Apr 12, 2017

Organization subpart

No

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

Authorized official

Name

Gregory Lance Guymon

Title

Coo

Phone

(405) 312-8050

Specialties & licenses 1

Addresses

Other names 1

• Teal Creek Assisted Living Doing business as

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

CLIA laboratory certificates

Practitioners 3

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

• Zane Glasgow

  • Physical Therapy Assistant
  • Edmond, OK
  • NPI 1801399183
  NPD (past)
• Cory Ryan Moore

  • Occupational Therapy Assistant
  • Edmond, OK
  • NPI 1952802167
  NPD (past)
• Kashawnda R Seamster

  • Physical Rehabilitation Occupational Therapist
  • Edmond, OK
  • NPI 1154810885
  NPD (past)

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491955200000",
    "number": "1396279808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13501 N. BRYANT AVE.",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "73013",
            "telephone_number": "405-312-8050",
            "fax_number": "866-542-6483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13501 N. BRYANT AVE.",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "73013",
            "telephone_number": "405-312-8050",
            "fax_number": "866-542-6483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEAL CREEK LIFE CARE COMMUNITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-12",
        "last_updated": "2017-04-12",
        "status": "A",
        "authorized_official_last_name": "GUYMON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "LANCE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "405-312-8050"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OK",
            "license": "AL5541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Teal Creek Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Latricia D Taylor, LPC-S, NCC
• Michael Joseph Taylor
• Morgan Rae Taylor
• Patricia A Taylor, PT CHT
• Zach Teague
• Mary Teal
• Robert L Teal
• Holly Tebow
• Kimberly Tedford
• Megan Teer

• Assisted Living Facility in Edmond, OK
• Providers in Edmond, OK by specialty
• Assisted Living Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.