Active NPI
Conhold of Sand Springs, LLC
Doing business as Sand Springs Nursing and Rehabilitation
- Skilled Nursing Facility
- Sand Springs, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- NH7217-7217
- Legal business name
- CONHOLD OF SAND SPRINGS, LLC
- Doing business as
- Sand Springs Nursing and Rehabilitation
- Practice address
- 1025 N Adams Rd
Sand Springs, OK 74063-8110 - Phone
- (918) 245-5908
- Fax
- (918) 774-9797
- NPI assigned
- Oct 9, 2013
- Last updated
- May 24, 2021
- Organization subpart
- Yes
- Parent organization
- TENANT ONE, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kim Thomas
- Title
- NA
- Phone
- (918) 774-9696
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NH7217-7217 | OK | Primary |
Addresses
Primary practice location
1025 N Adams Rd
Sand Springs, OK 74063-8110
Mailing address
111 E Chickasaw Ave
Sallisaw, OK 74955-4625
Phone (918) 774-9696
Other names 1
- Sand Springs Nursing and Rehabilitation
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140521000939 | OK | Part A Provider - Skilled Nursing Facility | 8729201777 | Practice locations: Sand Springs, OK |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1710314612. Details of each certification follow.
Skilled nursing facility certification: CCN 375285
- Legal name
- CONHOLD OF SAND SPRINGS, LLC
- Doing business as
- SAND SPRINGS NURSING AND REHABILITATION
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 1997
- Last certification
- Jun 21, 2024
- Beds
- 173
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Triacle, LLC
- Organization structure
- LLC
- Incorporated
- Nov 21, 2012 in OK
- Enrollment address
- 1025 North Adams
Sand Springs Nursing and Rehabilitation
Sand Springs, OK 74063-8110 - Nursing home name
- SAND SPRINGS NURSING AND REHABILITATION
- Affiliated entity
- CONHOLD
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Sand Springs Nursing and Rehabilitation
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jan 1, 1997
- Medicare certification status
- Active
- Certified beds
- 173
- Chain
- Conhold
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
- Penalties (3 years)
- 1
National Provider Directory
National Provider DirectoryLocations
111 E Chickasaw Ave
Sallisaw, OK 74955
Ownership & 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 |
|---|---|---|---|
| Sullivan Sand Springs TR | 5% Or Greater Direct Ownership Interest | Aug 29, 2013 | 45% |
| Armstrong Bank | 5% Or Greater Mortgage Interest | Aug 29, 2013 | 92% |
| Tenant One, LLC | 5% Or Greater Indirect Ownership Interest | Aug 29, 2013 | 55% |
| Comprehensive Management Services, Inc | Operational/Managerial Control | Aug 29, 2013 | 100% |
| James Frank Sullivan | 5% Or Greater Indirect Ownership Interest | Aug 29, 2013 | 100% |
| Operational/Managerial Control | Aug 29, 2013 | 100% | |
| Other | Aug 29, 2013 | 100% | |
| Amy Allred | W-2 Managing Employee | May 14, 2018 |
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.
-
- Internal Medicine Physician
- Tulsa, OK
- NPI 1104853142
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": "1381276800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1621814400000",
"number": "1710314612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 E CHICKASAW AVE",
"city": "SALLISAW",
"state": "OK",
"postal_code": "749554625",
"telephone_number": "918-774-9696",
"fax_number": "918-774-9797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 N ADAMS RD",
"city": "SAND SPRINGS",
"state": "OK",
"postal_code": "740638110",
"telephone_number": "918-245-5908",
"fax_number": "918-774-9797"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CONHOLD OF SAND SPRINGS, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "TENANT ONE, LLC",
"enumeration_date": "2013-10-09",
"last_updated": "2021-05-24",
"certification_date": "2021-05-24",
"status": "A",
"authorized_official_last_name": "THOMAS",
"authorized_official_first_name": "KIM",
"authorized_official_title_or_position": "NA",
"authorized_official_telephone_number": "918-774-9696"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "OK",
"license": "NH7217-7217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Sand Springs Nursing and Rehabilitation",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Sand Springs Nursing and Rehabilitation",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Sand Springs, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.