Heritage Park Management LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

HERITAGE PARK MANAGEMENT LLC

Practice address

6912 NW 23Rd St
Bethany, OK 73008-5219

Phone

(405) 789-7208

NPI assigned

Apr 22, 2024

Last updated

Apr 22, 2024By 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. Adamson Underwood

Title

Ceo

Phone

(405) 556-5333

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 1477308534. Details of each certification follow.

• CCN 375511 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 375511

Legal name

HERITAGE PARK MANAGEMENT, LLC

Doing business as

HERITAGE PARK

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Oct 1, 2007

Last certification

Oct 23, 2024

Beds

55

Ownership / control type

Corporation

Multi-facility organization

Voyage LLC

Most recent change of ownership

Apr 1, 2024

Organization structure

LLCProprietary

Enrollment address

6912 NW 23Rd St
Bethany, OK 73008-5219

Nursing home name

HERITAGE PARK

Listed as

Heritage ParkCCN 375511 · All quality measures

Overall star rating

1 of 5

Health inspections

2 of 5

Staffing

1 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Oct 1, 2007

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

5546.3 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Locations

All disclosed owners & managing parties 10

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.

• Muneer Ahmad Khan, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Oklahoma City, OK
  • NPI 1073504684

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 1

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

• Heritage Manor Management, LLC

  • Skilled Nursing Facility
  • Oklahoma City, OK
  • NPI 1679328728

  Voyage Management of Ok, 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.

• Muneer Ahmad Khan, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Oklahoma City, OK
  • NPI 1073504684
  NPD (past)

Affiliated clinicians 1

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

• Muneer Ahmad Khan, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Oklahoma City, OK
  • NPI 1073504684

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713744000000",
    "number": "1477308534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 S AIR DEPOT BLVD",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731104426",
            "telephone_number": "405-556-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6912 NW 23RD ST",
            "city": "BETHANY",
            "state": "OK",
            "postal_code": "730085219",
            "telephone_number": "405-789-7208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE PARK MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A",
        "authorized_official_last_name": "UNDERWOOD",
        "authorized_official_first_name": "ADAMSON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "405-556-5333",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krissy Anne Heiskell, OTD
• Siera Alexis Hemans, PT
• Linden A Hendricks
• Janice L. Hendryx
• Kyler Dean Hensley
• Jamie Hildenbrand, M.A., CCC-SLP
• Lynda Luann Hills, B.S M.ED
• Ryley Paige Hoch, SLP
• Chandler G Hoffman, OT
• Chelsie Nicole Hollas, MD, MPH

• Skilled Nursing Facility in Bethany, OK
• Providers in Bethany, 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 Apr 22, 2024; 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.