Active NPI
Village Health Services LLC
- Skilled Nursing Facility
- Broken Arrow, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- VILLAGE HEALTH SERVICES LLC
- Practice address
- 1709 S Main St
Broken Arrow, OK 74012-6502 - Phone
- (918) 251-2626
- NPI assigned
- Nov 30, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Colton Montgomery
- Title
- Owner
- Phone
- (918) 251-2626
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
1709 S Main St
Broken Arrow, OK 74012-6502
Mailing address
PO Box 668
Gore, OK 74435-0668
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230419000883 | OK | Part A Provider - Skilled Nursing Facility | 8426423781 | Practice locations: Broken Arrow, OK |
Skilled nursing facility certification: CCN 375171
- Legal name
- VILLAGE HEALTH SERVICES LLC
- Doing business as
- VILLAGE HEALTH CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 15, 1994
- Last certification
- Apr 11, 2024
- Beds
- 90
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC
- Incorporated
- Nov 10, 2021 in OK
- Enrollment address
- 1709 S Main St
Broken Arrow, OK 74012-6502 - Nursing home name
- VILLAGE HEALTH CARE CENTER
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Village Health Care Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Apr 15, 1994
- Medicare certification status
- Active
- Certified beds
- 90
- Penalties (3 years)
- 1
National Provider Directory
National Provider DirectoryLocations
4880 S Lewis Ave
Ste 100
Tulsa, OK 74105
Phone (918) 852-6861
Ownership & related parties
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Colton W Montgomery | 5% Or Greater Direct Ownership Interest | Dec 1, 2022 | 50% |
| Operational/Managerial Control | Dec 1, 2022 | ||
| Adp of the SNF | Dec 1, 2022 | ||
| Patty Woodhouse | Adp of the SNF | Dec 1, 2022 | |
| Taralee Montgomery | 5% Or Greater Direct Ownership Interest | Dec 1, 2022 | 50% |
| Adp of the SNF | Dec 1, 2022 | ||
| Angela M McGuire | Adp of the SNF | Apr 29, 2025 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- General Practice Physician
- Oklahoma City, OK
- NPI 1053492256
Adp of the SNF
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Physician
- Oklahoma City, OK
- NPI 1053492256
Affiliated clinicians 1
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": "1669766400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1674172800000",
"number": "1558071621",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 668",
"city": "GORE",
"state": "OK",
"postal_code": "744350668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1709 S MAIN ST",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740126502",
"telephone_number": "918-251-2626"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VILLAGE HEALTH SERVICES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-11-30",
"last_updated": "2023-01-20",
"certification_date": "2022-12-28",
"status": "A",
"authorized_official_last_name": "MONTGOMERY",
"authorized_official_first_name": "COLTON",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "918-251-2626",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Broken Arrow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.