Cedar Crest Manor Inc

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

NH1602-1602 Issued in OK

Legal business name

CEDAR CREST MANOR INC

Practice address

1700 NW Fort Sill Blvd
Lawton, OK 73507-4064

Phone

(580) 355-1616

Fax

(580) 355-2814

NPI assigned

Nov 13, 2006

Last updated

Jul 9, 2010By 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

Mrs. Tarri Aldridge

Title

Board Member

Phone

(580) 355-1616

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

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.

• Terry Hermance, MD

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1518980580
  NPD (past)

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278633600000",
    "number": "1689745291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NW FORT SILL BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735074064",
            "telephone_number": "580-355-1616",
            "fax_number": "580-355-2814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 NW FORT SILL BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735074064",
            "telephone_number": "580-355-1616",
            "fax_number": "580-355-2814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR CREST MANOR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2010-07-09",
        "status": "A",
        "authorized_official_last_name": "ALDRIDGE",
        "authorized_official_first_name": "TARRI",
        "authorized_official_title_or_position": "BOARD MEMBER",
        "authorized_official_telephone_number": "580-355-1616",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "OK",
            "license": "NH1602-1602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100773120A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL ID NUMBER",
            "identifier": "37E548",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Petra Casto
• Heather Castrogiovanni
• Marilyn Cater
• Cayla Caveny
• Neena Ceballos
• Martha Vivian Cendejas, RDH
• Ricardo Jose Cepero
• Mary Ellen Cerney, AAS-SLPA
• Chad D. Willis, D.O., P.C.
• Richard F Chadek, MD

• Nursing Facility/Intermediate Care Facility in Lawton, OK
• Providers in Lawton, OK by specialty
• Nursing Facility/Intermediate Care Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; 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.