NPIMap

Organization Active NPI

Southwest LTC - NW Okc, LLC

  • Skilled Nursing Facility
  • Oklahoma City, OK
National Provider Identifier
1700267754
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SOUTHWEST LTC - NW OKC, LLC
Practice address
2801 NW 61St St
Oklahoma City, OK 73112-7007
Phone
(405) 842-6601
Fax
(405) 810-8482
NPI assigned
Jun 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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

Authorized official

Name
Ronald R Payne, JD
Title
Ceo
Phone
(469) 916-6100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

2801 NW 61St St
Oklahoma City, OK 73112-7007

Mailing address

1518 Legacy Dr
Suite 110
Frisco, TX 75034-6038
Phone (469) 916-6100

Other names 1

  • Northwest Nursing Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160314001091 OK Part A Provider - Skilled Nursing Facility 5395041610 Practice locations: Oklahoma City, OK

Skilled nursing facility certification: CCN 375520

Legal name
SOUTHWEST LTC - NW OKC, LLC
Doing business as
NORTHWEST NURSING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 10, 2009
Last certification
Oct 31, 2024
Beds
100
Ownership / control type
Corporation
Multi-facility organization
Southwest LTC
Organization structure
LLCProprietary
Enrollment address
2801 NW 61St St
Oklahoma City, OK 73112-7007
Nursing home name
NORTHWEST NURSING CENTER
Affiliated entity
SOUTHWEST LTC

Care Compare: Nursing home

Medicare Care Compare
Listed as
Northwest Nursing CenterCCN 375520
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jun 10, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10058.5 residents per day on average
Chain
Southwest LTC10 facilities in the chain
Penalties (3 years)
1Fines totaling $10,062

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

2801 NW 61st St
Oklahoma City, OK 73112
Phone (405) 842-6601

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Ronald R Payne Individual 5% Or Greater Indirect Ownership InterestCeo Apr 27, 2015 72.89%
Operational/Managerial ControlCeo Jan 1, 2016 100%
Rod Baronet Individual 5% Or Greater Indirect Ownership Interest Apr 27, 2015 5.63%
Ronald R Payne PC Organization, Frisco, TX 5% Or Greater Indirect Ownership Interest Apr 27, 2015 72.89%
Barry D Hines Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2016 5.63%
Southwest LTC, LTD Organization, Frisco, TX 5% Or Greater Indirect Ownership Interest Apr 27, 2015 99%
Quality Care Givers Inc Organization, Frisco, TX Corporation 5% Or Greater Indirect Ownership Interest Apr 27, 2015 11.86%
Southwest LTC Management Services, LLC Organization, Frisco, TX LLC Operational/Managerial Control Jan 1, 2016
Southwest LTC Oklahoma Holdings, LLC Organization, Frisco, TX LLC 5% Or Greater Indirect Ownership Interest Apr 27, 2015 99%
Craig H Brashier Individual 5% Or Greater Indirect Ownership Interest Apr 27, 2015 9.41%

Facilities with the same owner 9

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1434412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434412800000",
    "number": "1700267754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1518 LEGACY DR",
            "address_2": "SUITE 110",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750346038",
            "telephone_number": "469-916-6100",
            "fax_number": "469-916-6105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 NW 61ST ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731127007",
            "telephone_number": "405-842-6601",
            "fax_number": "405-810-8482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST LTC - NW OKC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-16",
        "last_updated": "2015-06-16",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "469-916-6100",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.