NPIMap

Organization Active NPI

Willow Creek Health Care LLC

  • Skilled Nursing Facility
  • Guthrie, OK
National Provider Identifier
1497084693
Registry record updated Apr 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH4201 Issued in OK
Legal business name
WILLOW CREEK HEALTH CARE LLC
Practice address
2300 W Noble Ave
Guthrie, OK 73044-5504
Phone
(405) 282-1686
Fax
(405) 282-5731
NPI assigned
Dec 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Tandie Hastings
Title
Manager
Phone
(405) 282-6285

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH4201 OK Primary

Addresses

Primary practice location

2300 W Noble Ave
Guthrie, OK 73044-5504

Mailing address

PO Box 1095
Guthrie, OK 73044-1095
Phone (405) 282-6285

Other identifiers 1

IdentifierTypeStateIssuer
100778230AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100217000604 OK Part A Provider - Skilled Nursing Facility 9032253851 Practice locations: Guthrie, OK

Skilled nursing facility certification: CCN 375436

Legal name
WILLOW CREEK HEALTH CARE, LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 5, 2003
Last certification
Dec 11, 2024
Beds
100
Ownership / control type
Limited Liability Corporation
Most recent change of ownership
Jan 1, 2010
Organization structure
LLCProprietary
Incorporated
Jul 10, 2009 in OK
Enrollment address
2300 W Noble Ave
Guthrie, OK 73044-5504
Nursing home name
WILLOW CREEK HEALTH CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Willow Creek Health CareCCN 375436
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
May 5, 2003
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10049.2 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D0881076Willow Creek Health Care LLC2300 W Noble, Guthrie, OK 73044Certificate of waiverJan 3, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Laura Dutton Individual W-2 Managing EmployeeAdministrator Jan 1, 2010
Chappell 2012 Succession Trust Organization, Guthrie, OK 5% Or Greater Indirect Ownership Interest Jun 5, 2012 75.36%
Tandie D Hastings Individual Operational/Managerial ControlManager Apr 3, 2014 100%
Coles Nursing Home Organization, Guthrie, OK LLC 5% Or Greater Direct Ownership Interest Jan 1, 2010 100%
Mary Lou Chappell Trust Organization, Guthrie, OK 5% Or Greater Indirect Ownership Interest Jan 12, 2018 10.03%
HMLC LLC Organization, Guthrie, OK LLC 5% Or Greater Indirect Ownership Interest Jun 5, 2012 100%
Golden Age Nursing Home of Guthrie Inc. Organization, Guthrie, OK Corporation 5% Or Greater Indirect Ownership Interest Jun 5, 2012 7.9%

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1261008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334793600000",
    "number": "1497084693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1095",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730441095",
            "telephone_number": "405-282-6285",
            "fax_number": "405-282-5731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 W NOBLE AVE",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730445504",
            "telephone_number": "405-282-1686",
            "fax_number": "405-282-5731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW CREEK HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-17",
        "last_updated": "2012-04-19",
        "status": "A",
        "authorized_official_last_name": "HASTINGS",
        "authorized_official_first_name": "TANDIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "405-282-6285",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OK",
            "license": "NH4201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100778230A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Guthrie, OK

Sources for this page

Verify at the official NPI Registry.