NPIMap

Organization Active NPI

Pioneer Living Center Ops LLC

  • Intellectual Disabilities Intermediate Care Facility
  • Wetumka, OK
National Provider Identifier
1659217339
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
PIONEER LIVING CENTER OPS LLC
Practice address
623 S Alabama St
Wetumka, OK 74883-6034
Phone
(405) 452-3271
Fax
(405) 452-5154
NPI assigned
Apr 27, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Authorized official

Name
Kathy Suzette Baucom
Title
Regional Director
Phone
(479) 312-8280

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

623 S Alabama St
Wetumka, OK 74883-6034

Mailing address

1305 SE Adams St
Idabel, OK 74745-5240
Phone (580) 286-1065

Other names 1

  • Heartway at Pioneer Living Center - Redwood Place Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartway at Pioneer Living Center - Aspen Place6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1777248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777248000000",
    "number": "1659217339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 SE ADAMS ST",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747455240",
            "telephone_number": "580-286-1065",
            "fax_number": "580-286-3926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 S ALABAMA ST",
            "city": "WETUMKA",
            "state": "OK",
            "postal_code": "748836034",
            "telephone_number": "405-452-3271",
            "fax_number": "405-452-5154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER LIVING CENTER OPS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-27",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-26",
        "status": "A",
        "authorized_official_last_name": "BAUCOM",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "SUZETTE",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR",
        "authorized_official_telephone_number": "479-312-8280"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heartway at Pioneer Living Center - Redwood Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wetumka, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; 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.