Sulphur Manor Inc

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

NH5003-5003 Issued in OK

Legal business name

SULPHUR MANOR INC

Practice address

1300 W Lindsay Ave
Sulphur, OK 73086-6650

Phone

(580) 622-4600

Fax

(580) 622-5151

NPI assigned

Oct 4, 2005

Organization subpart

No

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

Authorized official

Name

Janice Pita

Title

Insurance/Medicare

Phone

(580) 622-6300

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Callaway Nursing Home Doing business as

Practitioners 2

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

• Drew K Cooper, MD

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1437180080
  NPD (past)
• Robert Oliver Morton, MD

  • Psychiatry Physician
  • Ada, OK
  • NPI 1336222504
  NPD (past)

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1508853508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W LINDSAY AVE",
            "city": "SULPHUR",
            "state": "OK",
            "postal_code": "730866650",
            "telephone_number": "580-622-4600",
            "fax_number": "580-622-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W LINDSAY AVE",
            "city": "SULPHUR",
            "state": "OK",
            "postal_code": "730866650",
            "telephone_number": "580-622-4600",
            "fax_number": "580-622-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULPHUR MANOR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "PITA",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "INSURANCE/MEDICARE",
        "authorized_official_telephone_number": "580-622-6300"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "OK",
            "license": "NH5003-5003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "000375401001",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100776290A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Callaway Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Southern Oklahoma Eye Center LLC
• Southern Oklahoma Treatment Services
• State of Oklahoma
• Sulphur Clinic Inc.
• Sulphur Dentistry & Braces
• Sulphur Public School
• Shaun E Swartz II
• Tessa Todd
• Teresa Truelock
• Robert Thomas Vallandingham, D.C.

• All providers in Sulphur, OK
• Nursing Facility/Intermediate Care Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.