NPIMap

Organization Active NPI

Azalea Park Manor LLC

Doing business as Grace Living Center - Muskogee

  • Skilled Nursing Facility
  • Muskogee, OK
National Provider Identifier
1699870329
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH5106-5106 Issued in OK
Legal business name
AZALEA PARK MANOR LLC
Doing business as
Grace Living Center - Muskogee
The Springs Skilled Nursing and Therapy
Practice address
4717 W Okmulgee St
Muskogee, OK 74401-4657
Phone
(918) 683-2914
Fax
(918) 683-3167
NPI assigned
Sep 14, 2006
Last updated
Feb 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

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

Authorized official

Name
Kristy Deroin
Title
Director of RCM
Phone
(405) 943-1144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH5106-5106 OK Primary

Addresses

Primary practice location

4717 W Okmulgee St
Muskogee, OK 74401-4657

Mailing address

5800 W Okmulgee St
Muskogee, OK 74401-4552
Phone (918) 683-2914

Other identifiers 1

IdentifierTypeStateIssuer
100772250AMedicaidOK

Other names 2

  • GRACE LIVING CENTER - MUSKOGEE Doing business as
  • The Springs Skilled Nursing and Therapy Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030320000035 OK Part A Provider - Skilled Nursing Facility 7113836388 Practice locations: Muskogee, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699870329. Details of each certification follow.

Skilled nursing facility certification: CCN 375159

Legal name
AZALEA PARK MANOR LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 1, 1994
Last certification
May 31, 2024
Beds
105
Ownership / control type
Partnership
Organization structure
LLCProprietary
Enrollment address
5800W Okmulgee St
Muskogee, OK 74401-4552
Nursing home name
THE SPRINGS SKILLED NURSING AND THERAPY
Affiliated entity
BRIDGES HEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
The Springs Skilled Nursing and TherapyCCN 375159 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
Apr 1, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10591.0 residents per day on average
Chain
Bridges Health33 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

5800 W Okmulgee St
Muskogee, OK 74401
Phone (918) 683-2914

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kristy Deroin Individual W-2 Managing EmployeeDirector of Reimbursement Jan 1, 2000
Bridges Esop, Inc Organization, Oklahoma City, OK Corporation 5% Or Greater Direct Ownership Interest Dec 31, 2020 100%
Operational/Managerial Control Dec 31, 2020 100%
Bridges Employee Stock Ownership Trust Organization, Lisle, IL Created for acquisition 5% Or Greater Indirect Ownership Interest Dec 31, 2020 100%
William Brett Coble Individual Corporate OfficerPresident/Manager Dec 31, 2020
Operational/Managerial ControlPresident/Manager Dec 31, 2020

Facilities with the same owner 33

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 33

Practitioners & affiliated clinicians

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.

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": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770249600000",
    "number": "1699870329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 W OKMULGEE ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744014552",
            "telephone_number": "918-683-2914",
            "fax_number": "918-683-3167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4717 W OKMULGEE ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744014657",
            "telephone_number": "918-683-2914",
            "fax_number": "918-683-3167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZALEA PARK MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A",
        "authorized_official_last_name": "DEROIN",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "DIRECTOR OF RCM",
        "authorized_official_telephone_number": "405-943-1144"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OK",
            "license": "NH5106-5106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100772250A",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "GRACE LIVING CENTER - MUSKOGEE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GRACE LIVING CENTER - MUSKOGEE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Springs Skilled Nursing and Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Muskogee, OK

Sources for this page

Verify at the official NPI Registry.