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
- 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
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 |
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 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 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
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.