Active NPI
Southwest LTC - Temple LLC
Doing business as Temple Manor Nursing Home
- Skilled Nursing Facility
- Temple, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- SOUTHWEST LTC - TEMPLE LLC
- Doing business as
- Temple Manor Nursing Home
- Practice address
- 100 West Green Ave
Temple, OK 73568 - Phone
- (580) 342-6228
- NPI assigned
- Feb 17, 2015
- 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
- Ronald Payne
- Title
- Manager
- Phone
- (469) 916-6100
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
100 West Green Ave
Temple, OK 73568
Mailing address
5560 Tennyson Pkwy Ste 210
Plano, TX 75024-3582
Phone (469) 916-6100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200645870A | Medicaid | OK | |
| NH1702 | Medicaid | OK |
Other names 1
- Temple Manor Nursing Home
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160212000747 | OK | Part A Provider - Skilled Nursing Facility | 0446554372 | Practice locations: Temple, OK |
Skilled nursing facility certification: CCN 375429
- Legal name
- SOUTHWEST LTC - TEMPLE LLC
- Doing business as
- TEMPLE MANOR NURSING HOME
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 3, 2003
- Last certification
- Jan 24, 2025
- Beds
- 48
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Southwest LTC
- Most recent change of ownership
- Dec 1, 2015
- Organization structure
- LLC
- Incorporated
- Dec 1, 2015 in TX
- Enrollment address
- 100 West Green Avenue
Temple, OK 73568-0001 - Nursing home name
- TEMPLE MANOR NURSING HOME
- Affiliated entity
- SOUTHWEST LTC
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Temple Manor Nursing Home
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jan 3, 2003
- Medicare certification status
- Active
- Certified beds
- 48
- Chain
- Southwest LTC
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 9
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 |
|---|---|---|---|
| Isaac S Dole | 5% Or Greater Indirect Ownership Interest | Oct 1, 2015 | 25% |
| Ronald R Payne | 5% Or Greater Indirect Ownership Interest | Oct 1, 2015 | 54.46% |
| Operational/Managerial Control | Dec 1, 2015 | 100% | |
| Ronald R Payne PC | 5% Or Greater Indirect Ownership Interest | Oct 1, 2015 | 54.46% |
| Operational/Managerial Control | Oct 1, 2015 | 100% | |
| BHCP Ok3 Sponsor, LLC | 5% Or Greater Direct Ownership Interest | Dec 1, 2015 | 25% |
| Southwest LTC, LTD | 5% Or Greater Indirect Ownership Interest | Oct 1, 2015 | 75% |
| Quality Care Givers Inc | 5% Or Greater Indirect Ownership Interest | Oct 1, 2015 | 8.99% |
| Southwest LTC Management Services, LLC | Operational/Managerial Control | Dec 1, 2015 | 100% |
| Southwest LTC Oklahoma Holdings, LLC | 5% Or Greater Direct Ownership Interest | Dec 1, 2015 | 75% |
| Craig H Brashier | 5% Or Greater Indirect Ownership Interest | Oct 1, 2015 | 7.13% |
Facilities with the same owner 9
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Hobart Nursing & Rehabilitation
- Skilled Nursing Facility
- Hobart, OK
- NPI 1598488769
Quality Care Givers Inc, Ronald R Payne PC, Southwest LTC Management Services, LLC, Southwest LTC Oklahoma Holdings, LLC, Southwest LTC, LTD
-
dba Northwest Nursing Center
- Skilled Nursing Facility
- Oklahoma City, OK
- NPI 1700267754
Quality Care Givers Inc, Ronald R Payne PC, Southwest LTC Management Services, LLC, Southwest LTC Oklahoma Holdings, LLC, Southwest LTC, LTD
-
dba Heritage at Brandon Place
- Skilled Nursing Facility
- Oklahoma City, OK
- NPI 1447631494
Quality Care Givers Inc, Ronald R Payne PC, Southwest LTC Management Services, LLC, Southwest LTC Oklahoma Holdings, LLC, Southwest LTC, LTD
-
dba Willow Park Healthcare Center
- Skilled Nursing Facility
- Lawton, OK
- NPI 1588055206
Quality Care Givers Inc, Ronald R Payne PC, Southwest LTC Management Services, LLC, Southwest LTC Oklahoma Holdings, LLC, Southwest LTC, LTD
-
dba Tuttle Care Center
- Skilled Nursing Facility
- Tuttle, OK
- NPI 1861884348
BHCP Ok3 Sponsor, LLC, Quality Care Givers Inc, Ronald R Payne PC, Southwest LTC Management Services, LLC, Southwest LTC Oklahoma Holdings, LLC, Southwest LTC, LTD
-
- Community Based Hospice Care Agency
- Monroe, LA
- NPI 1639483738
Quality Care Givers Inc
-
- Psychiatric Hospital
- Bossier City, LA
- NPI 1881638880
Quality Care Givers Inc
-
dba The Village at Heritage Oaks
- Skilled Nursing Facility
- Corsicana, TX
- NPI 1649735036
Quality Care Givers Inc, Southwest LTC, LTD
-
dba Legacy West Rehabilitation and Healthcare
- Skilled Nursing Facility
- Corsicana, TX
- NPI 1730644121
Quality Care Givers Inc, Ronald R Payne PC, Southwest LTC, LTD
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Oklahoma City, OK
- NPI 1518980580
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424131200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1659484800000",
"number": "1639560337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5560 TENNYSON PKWY STE 210",
"city": "PLANO",
"state": "TX",
"postal_code": "750243582",
"telephone_number": "469-916-6100",
"fax_number": "469-916-6105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 WEST GREEN AVE",
"city": "TEMPLE",
"state": "OK",
"postal_code": "73568",
"telephone_number": "580-342-6228"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHWEST LTC - TEMPLE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-02-17",
"last_updated": "2022-08-03",
"certification_date": "2022-08-03",
"status": "A",
"authorized_official_last_name": "PAYNE",
"authorized_official_first_name": "RONALD",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "469-916-6100"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200645870A",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NH1702",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Temple Manor Nursing Home",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Temple Manor Nursing Home",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Temple, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.