NPIMap

Organization Active NPI

Heartway Corporation

  • Skilled Nursing Facility
  • Muskogee, OK
National Provider Identifier
1720066434
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH5112-5112 Issued in OK
Legal business name
HEARTWAY CORPORATION
Practice address
500 S York St
Muskogee, OK 74403
Phone
(918) 682-6724
Fax
(918) 682-8090
NPI assigned
Jan 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

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

Authorized official

Name
Kathy Suzette Baucom
Title
Treasurer
Phone
(580) 286-1065

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH5112-5112 OK Primary

Addresses

Primary practice location

500 S York St
Muskogee, OK 74403

Mailing address

500 S York St
Muskogee, OK 74403-5956
Phone (918) 682-6724

Other identifiers 1

IdentifierTypeStateIssuer
100779190AMedicaidOK

Other names 1

  • York Manor Nursing Home Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address suzie.ezell.42@heartway.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190530000277 OK Part A Provider - Skilled Nursing Facility 7214938463 Practice locations: Muskogee, OK

Skilled nursing facility certification: CCN 375132

Legal name
HEARTWAY CORPORATION
Doing business as
YORK MANOR NURSING HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 20, 1993
Last certification
Jan 29, 2025
Beds
60
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Heartway Corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 14, 1987 in TX
Enrollment address
500 South York Street
Muskogee, OK 74403-5956
Nursing home name
YORK MANOR NURSING HOME

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
York Manor Nursing HomeCCN 375132
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
4 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jan 20, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6039.3 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2141981York Manor Nursing Home500 South York Street, Muskogee, OK 74403Certificate of waiverDec 27, 2027

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Kathy Baucom Individual Corporate OfficerTreasurer Mar 15, 2023
Operational/Managerial ControlRegional Director Sep 10, 2010 50%
Adp of the SNF Sep 20, 2010
Individual Adp of the SNF Jan 9, 2023
Bokf,NA Organization, Tulsa, OK Financial institution Adp of the SNF Nov 16, 2021
Blaine Barton Individual Corporate OfficerDirector Mar 15, 2023 20%
Corporate DirectorDirector, Board of Directors Mar 15, 2023 20%
Operational/Managerial Control Mar 15, 2023
Managing Control - Governing BodyDirector, Board of Directors Mar 15, 2023
Andrew E Sanford Individual Corporate OfficerSecretary Mar 15, 2023 20%
Corporate DirectorSecretary, Board of Directors Mar 15, 2023 20%
Operational/Managerial Control Mar 15, 2023
Managing Control - Governing BodySecretary Mar 15, 2023
Adp of the SNF Mar 15, 2023
Thomas W Salyer Individual Corporate OfficerVice President Mar 15, 2023 20%
Corporate DirectorVice President, Board of Directo Mar 15, 2023 20%
Operational/Managerial Control Mar 15, 2023
Managing Control - Governing BodyDirector, Board of Directors Mar 15, 2023
Terry C Hermance Individual Operational/Managerial Control Aug 1, 2023
Adp of the SNF Aug 1, 2023
Jan Darby Individual Corporate OfficerDirector Feb 5, 2025 20%
Corporate DirectorDirector Feb 5, 2025 20%
Nutrition Management Services Inc. Organization, Broken Arrow, OK Consulting firm Adp of the SNF Jan 1, 2013
Forvis Mazars LLP Organization, Springfield, MO Consulting firm Operational/Managerial Control Jan 9, 2023
Adp of the SNF Mar 26, 2025
Andrea Marshall Individual Operational/Managerial Control Sep 8, 2023
Adp of the SNF Sep 8, 2023
Randall G Blue Individual Corporate OfficerPresident Mar 15, 2023 20%
Corporate DirectorPresident, Board of Directors Mar 15, 2023 20%
Operational/Managerial ControlHealthcare Director Mar 15, 2023 50%
Managing Control - Governing BodyPresident, Board of Directors Mar 15, 2023
Adp of the SNF Mar 15, 2023
Justin Taylor Individual Adp of the SNF Jan 8, 2024
Individual Adp of the SNF Apr 15, 2014
Shirley J Breashears Individual Operational/Managerial Control Mar 16, 2023
Adp of the SNF Mar 16, 2023
Tno Holdings, LLC Organization, West Melbourne, FL Created for acquisition, LLC, Holding company 5% Or Greater Mortgage Interest Dec 21, 2021 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 87

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

View all 87

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771200000000",
    "number": "1720066434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S YORK ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744035956",
            "telephone_number": "918-682-6724",
            "fax_number": "918-682-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S YORK ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "74403",
            "telephone_number": "918-682-6724",
            "fax_number": "918-682-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTWAY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-03",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A",
        "authorized_official_last_name": "BAUCOM",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "SUZETTE",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "580-286-1065"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OK",
            "license": "NH5112-5112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100779190A",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "suzie.ezell.42@heartway.org",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "500 S York St",
            "city": "Muskogee",
            "state": "OK",
            "country_code": "US",
            "postal_code": "74403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "York Manor Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "York Manor Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Muskogee, OK

Sources for this page

Verify at the official NPI Registry.