Active NPI
Clinton Therapy & Living Center, LLC
- Skilled Nursing Facility
- Clinton, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- CLINTON THERAPY & LIVING CENTER, LLC
- Practice address
- 2316 W Modelle Ave
Clinton, OK 73601-3722 - Phone
- (580) 323-0912
- Fax
- (580) 323-4935
- NPI assigned
- Nov 15, 2017
- Last updated
- Nov 15, 2017
- 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. Michael Brandon Morgan
- Title
- Ceo
- Phone
- (479) 769-5535
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | OK | Primary |
Addresses
Primary practice location
2316 W Modelle Ave
Clinton, OK 73601-3722
Mailing address
2316 W Modelle Ave
Clinton, OK 73601-3722
Phone (580) 323-0912
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180104000507 | OK | Part A Provider - Skilled Nursing Facility | 9335408921 | Practice locations: Clinton, OK |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1669985305. Details of each certification follow.
Skilled nursing facility certification: CCN 375253
- Legal name
- CLINTON THERAPY & LIVING CENTER, LLC
- Doing business as
- CLINTON THERAPY & LIVING CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 1, 1996
- Last certification
- Jun 5, 2025
- Beds
- 101
- Ownership / control type
- Limited Liability Corporation
- Most recent change of ownership
- Dec 1, 2017
- Organization structure
- LLC
- Enrollment address
- 2316 W Modelle Ave
Clinton, OK 73601-3722 - Nursing home name
- CLINTON THERAPY & LIVING CENTER
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Clinton Therapy & Living Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jul 1, 1996
- Medicare certification status
- Active
- Certified beds
- 101
- Penalties (3 years)
- 12
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 6
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 |
|---|---|---|---|
| KTFW-Ok, LLC | 5% Or Greater Mortgage Interest | Dec 1, 2017 | 100% |
| Adp of the SNF | Dec 1, 2017 | ||
| Lisa Childree | Operational/Managerial Control | Oct 2, 2023 | |
| Adp of the SNF | Oct 2, 2023 | ||
| Joshua a Kilgore | 5% Or Greater Direct Ownership Interest | Jan 26, 2024 | 100% |
| Operational/Managerial Control | Dec 1, 2014 | ||
| Drew K Cooper | Adp of the SNF | Dec 1, 2017 | |
| 2316WM LLC | 5% Or Greater Mortgage Interest | Dec 1, 2017 | 100% |
| Adp of the SNF | Dec 1, 2017 | ||
| Kilgore Family Trust-2012 | 5% Or Greater Mortgage Interest | Dec 1, 2017 | 100% |
| Adp of the SNF | Dec 1, 2017 |
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 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Skilled Nursing Facility
- Chandler, OK
- NPI 1679937981
-
- Family Medicine Physician
- Oklahoma City, OK
- NPI 1437180080
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": "1510704000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1510704000000",
"number": "1669985305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2316 W MODELLE AVE",
"city": "CLINTON",
"state": "OK",
"postal_code": "736013722",
"telephone_number": "580-323-0912",
"fax_number": "580-323-4935"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2316 W MODELLE AVE",
"city": "CLINTON",
"state": "OK",
"postal_code": "736013722",
"telephone_number": "580-323-0912",
"fax_number": "580-323-4935"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLINTON THERAPY & LIVING CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-11-15",
"last_updated": "2017-11-15",
"status": "A",
"authorized_official_last_name": "MORGAN",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "BRANDON",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "479-769-5535",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "OK",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clinton, OK
- Clinton Indian Health Center
- Clinton Indian Health Center (Clinton IHS Pharmacy)
- Clinton Nursing and Rehab LLC (Clinton Nursing and Rehab)
- Clinton Nursing Center, LLC (Grace Living Center - Clinton)
- Clinton Public Schools
- Clintonweatherford RT Associates LLC (Artesian Cancer Center @ Clinton)
- Sherri Ann Cloninger
- Angela Carin Cloud, LPN
- James Doyle Coffey, O.D.
- Melissa Suzanne Collins
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2017; 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.