NPIMap

Convalescent Center of Grady County

Organization Active NPI Skilled Nursing Facility · Chickasha, OK

NPI 1487759106 · NPPES record last updated Feb 5, 2026

Key facts

NPI
1487759106
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
License
NH2603-2603 (OK)
Legal business name
CONVALESCENT CENTER OF GRADY COUNTY
Practice address
2300 W Iowa Ave
Chickasha, OK 73018-2507
Phone
(405) 224-6456
Fax
(405) 224-9252
NPI assigned
Sep 14, 2006
Organization subpart
No

Authorized official

Name
Kristy Deroin
Title
Director of Reimbursement
Phone
(405) 943-1144

Facilities with the same owner 33

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

View all 33

Practitioners 2

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

Affiliated clinicians 2

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

Medicare Care Compare: Nursing home

Listed as
Cottonwood Creek Skilled Nursing & Therapy CCN 375144
Overall star rating
★★★★☆ 4 of 5
Health inspections
★★★★☆ 4 of 5
Staffing
★★★☆☆ 3 of 5
Quality measures
★★☆☆☆ 2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
Nov 1, 1993
Medicare certification status
Active (Provider of Services file)
Certified beds
120 · 68.3 residents per day on average
Chain
Bridges Health (33 facilities)

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OK

Skilled nursing facility certification: CCN 375144

Legal name
CONVALESCENT CENTER OF GRADY COUNTY
Doing business as
GRACE LIVING CENTER - CHICKASHA
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 1, 1993
Last certification
Feb 6, 2025
Beds
120
Ownership / control type
Partnership
Organization structure
LLC · Proprietary
Incorporated
Apr 20, 1993 in OK
Enrollment address
2300 W Iowa Ave
Chickasha, OK 73018-2507
Nursing home name
COTTONWOOD CREEK SKILLED NURSING & THERAPY
Affiliated entity
BRIDGES HEALTH

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Kristy Deroin
Individual 		W-2 Managing Employee
Director of Revenue Cycle Managemen		 Dec 31, 2020
Bridges Esop, Inc
Organization · Oklahoma City, OK
Corporation 		5% Or Greater Direct Ownership Interest Dec 31, 2020 100%
Operational/Managerial Control Dec 31, 2020 100%
Bridges Employee Stock Ownership Trust
Organization · Lisle, IL
Created for acquisition 		5% Or Greater Indirect Ownership Interest Dec 31, 2020 100%
William Brett Coble
Individual 		Corporate Officer
President		 Dec 31, 2020
Operational/Managerial Control
President		 Dec 31, 2020

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20030320000030 OK Part a Provider - Skilled Nursing Facility 3577472745 Practice locations: Chickasha, OK

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH2603-2603 OK Yes

Addresses

Primary practice location

2300 W Iowa Ave
Chickasha, OK 73018-2507

Mailing address

2300 W Iowa Ave
Chickasha, OK 73018-2507
Phone (405) 224-6456

Other identifiers

IdentifierTypeStateIssuer
100685060BMedicaidOK

Other names

  • GRACE LIVING CENTER - CHICKASHA Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Other providers in Chickasha, OK

All providers in Chickasha, OK · Skilled Nursing Facility in Oklahoma

Sources for this page

Verify at the official NPI Registry.