Organization Active NPI

Village Health Services LLC

  • Skilled Nursing Facility
  • Broken Arrow, OK
National Provider Identifier
1558071621
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
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

Updated by the provider on Jan 20, 2023

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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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
LLCProprietary
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 CenterCCN 375171 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
1 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Apr 15, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9050.2 residents per day on average
Penalties (3 years)
1Fines totaling $28,744

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

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.

NameRoleSinceShare
Colton W Montgomery Individual 5% Or Greater Direct Ownership InterestManaging Member Dec 1, 2022 50%
Operational/Managerial Control Dec 1, 2022
Adp of the SNF Dec 1, 2022
Patty Woodhouse Individual Adp of the SNF Dec 1, 2022
Taralee Montgomery Individual 5% Or Greater Direct Ownership InterestManaging Member Dec 1, 2022 50%
Adp of the SNF Dec 1, 2022
Angela M McGuire Individual 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.

Practitioners & affiliated clinicians

Practitioners 1

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

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

Verify at the official NPI Registry.