Beacon Ridge SNF Operations LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

BEACON RIDGE SNF OPERATIONS LLC

Doing business as

Beacon Ridge

Practice address

102 E Line Ave
Sapulpa, OK 74066-2858

Phone

(918) 216-1811

Fax

(918) 514-6709

NPI assigned

Aug 16, 2022

Last updated

Jan 5, 2023By 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

David Ganz

Title

Manager

Phone

(832) 422-8848

Specialties & licenses 1

Addresses

Other names 1

• Beacon Ridge Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417675471. Details of each certification follow.

• CCN 375572 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 375572

Legal name

BEACON RIDGE SNF OPERATIONS LLC

Doing business as

BEACON RIDGE SENIOR MENTAL HEALTH

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Apr 26, 2018

Last certification

Nov 21, 2024

Beds

69

Ownership / control type

Limited Liability Corporation

Most recent change of ownership

Jan 6, 2023

Organization structure

LLCProprietary

Incorporated

Mar 15, 2022 in OK

Enrollment address

102 E Line Ave
Sapulpa, OK 74066-2858

Nursing home name

BEACON RIDGE

Affiliated entity

SKYBLUE HEALTHCARE

Listed as

Beacon RidgeCCN 375572 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

3 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Apr 26, 2018

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6951.4 residents per day on average

Chain

Skyblue Healthcare12 facilities in the chain

Penalties (3 years)

2Fines totaling $0

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 9

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.

• Rodger Brannon Spillars, M.D.

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1679508568

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 4

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

• Arbor SNF Operations LLC

  dba Arbor Village

  • Skilled Nursing Facility
  • Sapulpa, OK
  • NPI 1033837067

  Rivers Edge Operations LLC, Rivers Edge Partners LLC

  CMS ownership
• Bell Ave SNF Operations LLC

  dba Bell Avenue Nursing Center

  • Skilled Nursing Facility
  • Elk City, OK
  • NPI 1588382543

  Rivers Edge Operations LLC, Rivers Edge Partners LLC

  CMS ownership
• Cross Timbers SNF Operations LLC

  dba Cross Timbers Nursing and Rehabilitation

  • Skilled Nursing Facility
  • Midwest City, OK
  • NPI 1386362093

  Rivers Edge Partners LLC

  CMS ownership
• Linwood Village Operations LLC

  dba Linwood Village Nursing & Retirement Apts

  • Skilled Nursing Facility
  • Cushing, OK
  • NPI 1376261339

  Rivers Edge Operations LLC, Rivers Edge Partners LLC

  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.

• Rodger Brannon Spillars, M.D.

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1679508568
  NPD (past)

Affiliated clinicians 1

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

• Rodger Brannon Spillars, M.D.

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1679508568

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672876800000",
    "number": "1417675471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 E LINE AVE",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740662858",
            "telephone_number": "918-216-1811",
            "fax_number": "918-514-6709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E LINE AVE",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740662858",
            "telephone_number": "918-216-1811",
            "fax_number": "918-514-6709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON RIDGE SNF OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-16",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A",
        "authorized_official_last_name": "GANZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "832-422-8848"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beacon Ridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura E Barrett
• Vanda Bartlett
• Chance Batey
• Tracy Battle
• Rebecca Ann Beach, DPT
• Kristina Parsons Beck, M.S., CCC-SLP
• Katresse Bedwell
• John C Bell, LPC
• Logan Belveal
• Juliann Shalee Bennett

• Skilled Nursing Facility in Sapulpa, OK
• Providers in Sapulpa, 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 Jan 5, 2023; 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.