NPIMap

Organization Active NPI

Serenity Residential Home Care

  • Adult Care Home Facility
  • Oklahoma City, OK
National Provider Identifier
1518312404
Registry record updated Apr 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Legal business name
SERENITY RESIDENTIAL HOME CARE
Practice address
1129 N Harvard Ave
Oklahoma City, OK 73127-4021
Phone
(405) 946-3341
Fax
(405) 272-1630
NPI assigned
Apr 28, 2016
Last updated
Apr 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2016

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

Authorized official

Name
Mr. Timothy Lee Shoals Sr., BSNPI 1053630848
Title
Owner
Phone
(405) 361-7643

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X NU Primary

Addresses

Primary practice location

1129 N Harvard Ave
Oklahoma City, OK 73127-4021

Mailing address

214 SW 30TH St
Oklahoma City, OK 73109-6506
Phone (405) 361-7643

National Provider Directory

National Provider Directory

Locations

214 SW 30th St
Oklahoma City, OK 73109
Phone (405) 272-1610

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461801600000",
    "number": "1518312404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 SW 30TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731096506",
            "telephone_number": "405-361-7643",
            "fax_number": "405-272-1630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 N HARVARD AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731274021",
            "telephone_number": "405-946-3341",
            "fax_number": "405-272-1630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY RESIDENTIAL HOME CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-28",
        "last_updated": "2016-04-28",
        "status": "A",
        "authorized_official_last_name": "SHOALS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-361-7643",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; 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.