Wildwood Management Company, L.L.C.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH7209-7209 Issued in OK

Legal business name

WILDWOOD MANAGEMENT COMPANY, L.L.C.

Doing business as

Wildwood Care Center

Practice address

3333 E 28TH St
Tulsa, OK 74114-5915

Phone

(918) 747-8008

Fax

(918) 748-5970

NPI assigned

Feb 14, 2007

Last updated

May 31, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ed Rucker

Title

Member

Phone

(918) 743-7838

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wildwood Care Center Doing business as

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306800000000",
    "number": "1578605481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 E SKELLY DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741055919",
            "telephone_number": "918-743-7838",
            "fax_number": "918-748-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 E 28TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741145915",
            "telephone_number": "918-747-8008",
            "fax_number": "918-748-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDWOOD MANAGEMENT COMPANY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2011-05-31",
        "status": "A",
        "authorized_official_last_name": "RUCKER",
        "authorized_official_first_name": "ED",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "918-743-7838",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OK",
            "license": "NH7209-7209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200119170A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wildwood Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wild Hearth LLC (wild ember)
• Christine Ann Wilde
• Summer Luann Wilde, RSS
• Daniel E Wildes, D.O.
• Wildwood Care Center
• Jessica Wiles
• Jeania Marie Wiley, MS, LPC, NCC
• Jodi Lee Wiley, DO
• Kaleb Wiley
• Kelsey L Wiley, LMSW

• Skilled Nursing Facility in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Skilled Nursing Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2011; 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.