Corn Heritage Village of Corn Inc

Key facts

NPI: 1396973210
Entity type: Organization (NPI type 2)
Primary specialty: Nursing Facility/Intermediate Care Facility 313M00000X
License: NH7502-7502 (OK)
Legal business name: CORN HERITAGE VILLAGE OF CORN INC
Practice address: 106 W Adams Street
Corn, OK 73024
Phone: (580) 343-2295
Fax: (580) 343-2297
NPI assigned: Jun 30, 2009
Organization subpart: No

Authorized official

Name: Mr. Martin Hall
Title: Executive Director
Phone: (580) 343-2295

Owners & managing parties with NPI records 1

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

Michael E Aaron, M.D. Family Medicine Physician · Weatherford, OK · NPI 1700958659

CMS ownership ADP OF THE SNF

Practitioners 1

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

Michael E Aaron, M.D. Family Medicine Physician · Weatherford, OK · NPI 1700958659

NPD (past)

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Blake Allen Badgett, M.D. Family Medicine Physician · Weatherford, OK · NPI 1376636084

Care Compare affiliation Nursing home
J M Huser III, M.D. Family Medicine Physician · Weatherford, OK · NPI 1699750554

Care Compare affiliation Nursing home

Medicare Care Compare: Nursing home

Listed as: Corn Heritage Village and Rehab CCN 375409
Overall star rating: ★☆☆☆☆ 1 of 5
Health inspections: ★☆☆☆☆ 1 of 5
Staffing: ★★☆☆☆ 2 of 5
Quality measures: ★★☆☆☆ 2 of 5
Type: Medicare and Medicaid
Ownership: Non profit - Church related
Certified: May 14, 2002
Medicare certification status: Active (Provider of Services file)
Certified beds: 104 · 53.5 residents per day on average
Penalties (3 years): 2 · fines totaling $50,622

Source: Medicare Care Compare, processed Aug 1, 2026.

Medicare participation

Medicare fee-for-service enrollment: Enrolled in OK

Skilled nursing facility certification: CCN 375409

Legal name: CORN HERITAGE VILLAGE OF CORN INC
Doing business as: CORN HERITAGE VILLAGE AND REHAB
Certification status: Active
Provider type (POS): Nursing home – SNF/NF dual certification
Participating since: May 14, 2002
Last certification: Nov 21, 2024
Beds: 104
Ownership / control type: Church Related
Organization structure: Corporation · Non-profit
Incorporated: Mar 6, 2009 in OK
Enrollment address: 106 W Adams Street
Corn Heritage Village
Corn, OK 73024-9601
Nursing home name: CORN HERITAGE VILLAGE AND REHAB

All disclosed owners & managing parties 22

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

Name	Role	Since
Jonathan Peters Individual	Corporate Director Vice Chair	Sep 30, 2019
Organization · Springfield, MO Consulting firm	Adp of the SNF	Mar 31, 2025
William Brown Individual	Operational/Managerial Control	Jan 1, 2025
Marci Russell Individual	Corporate Director Board Member	Jan 1, 2024
Organization · Weatherford, OK Financial institution	Adp of the SNF	Apr 3, 2025
Organization · Atlanta, GA Corporation, For-profit	Adp of the SNF	Mar 31, 2025
Sarah Boyd Individual	Operational/Managerial Control	Jan 1, 2025
Bart Gossen Individual	Corporate Director Board Member	Jan 1, 2024
Organization · Weatherford, OK Financial institution	Adp of the SNF	Mar 31, 2025
Michael E Aaron Individual	Adp of the SNF	Feb 1, 2018
Organization · Walnut, CA Corporation, Medical staffing company, For-profit	Adp of the SNF	Mar 31, 2025
Rachel Peek Individual	Operational/Managerial Control	Jan 1, 2025
Aaron McDonald Individual	Operational/Managerial Control	Jun 28, 2024
Aaron McDonald Individual	Adp of the SNF	Mar 31, 2025
Organization · Dallas, TX LLC, Medical staffing company, For-profit	Adp of the SNF	Mar 31, 2025
Melissa Morgan Individual	Operational/Managerial Control	Jan 1, 2025
Bettina King Individual	Operational/Managerial Control	Jan 1, 2025
Individual	Adp of the SNF	Sep 1, 2010
Sheriffdeen M Raji Individual	Corporate Director Executive Director	Jun 20, 2014
Individual	Adp of the SNF	Aug 1, 2023
Howard Bartel Individual	Corporate Director Secretary	Aug 1, 2020
Organization · Denton, TX LLC, Medical staffing company, For-profit	Adp of the SNF	Mar 31, 2025
Clair Redcay Individual	Corporate Officer Board President	Sep 27, 2021

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20091214000593	OK	Part a Provider - Skilled Nursing Facility	9830239334	Practice locations: Corn, OK

National Provider Directory

Locations

106 W Adams St
Corn, OK 73024
Phone (580) 343-2295

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Nursing Facility/Intermediate Care Facility	313M00000X	NH7502-7502	OK	Yes

Addresses

Primary practice location

106 W Adams Street
Corn, OK 73024

Mailing address

PO Box 98
Corn, OK 73024-0098
Phone (580) 343-2295

Other identifiers

Identifier	Type	State	Issuer
200265350A	Medicaid	OK

Other providers in Corn, OK

All providers in Corn, OK · Nursing Facility/Intermediate Care Facility in Oklahoma

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2009. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
Provider of Services files (CMS): certification status, beds and related CCNs.
Medicare Care Compare provider data (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.