Corn Heritage Village of Corn Inc

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

NH7502-7502 Issued in 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

Last updated

Dec 9, 2009By 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

Mr. Martin Hall

Title

Executive Director

Phone

(580) 343-2295

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396973210. Details of each certification follow.

• CCN 375409 Skilled nursing facility · Active · Details

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

CorporationNon-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

Listed as

Corn Heritage Village and RehabCCN 375409 · All quality measures

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

ActiveFrom the Provider of Services file

Certified beds

10453.5 residents per day on average

Penalties (3 years)

2Fines totaling $50,622

Processed by Care Compare on Aug 1, 2026.

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.

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

  Adp of the SNF

  CMS 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.

• 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

  Nursing home

  Care Compare affiliation
• J M Huser III, M.D.

  • Family Medicine Physician
  • Weatherford, OK
  • NPI 1699750554

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260316800000",
    "number": "1396973210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98",
            "city": "CORN",
            "state": "OK",
            "postal_code": "730240098",
            "telephone_number": "580-343-2295",
            "fax_number": "580-343-2297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 W ADAMS STREET",
            "city": "CORN",
            "state": "OK",
            "postal_code": "73024",
            "telephone_number": "580-343-2295",
            "fax_number": "580-343-2297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORN HERITAGE VILLAGE OF CORN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-30",
        "last_updated": "2009-12-09",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "580-343-2295",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "OK",
            "license": "NH7502-7502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corn the Mennonite Brethren Church of Corn Ok
• Leah Lorene Dowty, PTA
• Kendra Eastwood
• Jenna Sue Scales

• Nursing Facility/Intermediate Care Facility in Corn, OK
• Providers in Corn, OK by specialty
• Nursing Facility/Intermediate Care Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2009; 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.