Lakeview Nursing & Rehab LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

LAKEVIEW NURSING & REHAB LLC

Doing business as

Lakeview Nursing & Rehab

Practice address

607 Woodland St
Eufaula, OK 74432-3611

Phone

(918) 689-2508

Fax

(405) 252-5632

NPI assigned

Dec 26, 2018

Last updated

Jun 7, 2024By 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

Bradford Montgomery

Title

Member

Phone

(479) 899-2010

Specialties & licenses 1

Addresses

Other names 1

• Lakeview Nursing & Rehab Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730651001. Details of each certification follow.

• CCN 375575 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 375575

Legal name

LAKEVIEW NURSING & REHAB LLC

Doing business as

LAKEVIEW NURSING & REHAB

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jul 15, 2019

Last certification

Feb 13, 2025

Beds

70

Ownership / control type

Corporation

Multi-facility organization

Interhealth Management

Organization structure

LLCProprietary

Incorporated

Jan 16, 2018 in OK

Enrollment address

607 Woodland St
Eufaula, OK 74432-3611

Nursing home name

LAKEVIEW NURSING & REHAB

Affiliated entity

BRADFORD MONTGOMERY

Listed as

Lakeview Nursing & RehabCCN 375575 · All quality measures

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

2 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Jul 15, 2019

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

7051.3 residents per day on average

Chain

Bradford Montgomery11 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

All disclosed owners & managing parties 2

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

Practitioners 3

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.

• Ryan Kyle Aldrich, MD

  • Family Medicine Physician
  • Shawnee, OK
  • NPI 1760555130
  NPD (past)
• Jack Howard Brown Jr., MD, DPM

  • Family Medicine Physician
  • Sand Springs, OK
  • NPI 1982699096
  NPD (past)
• 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": "1545782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717718400000",
    "number": "1730651001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 PROFESSIONAL DR",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727158462",
            "telephone_number": "479-715-6759",
            "fax_number": "479-715-6922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 WOODLAND ST",
            "city": "EUFAULA",
            "state": "OK",
            "postal_code": "744323611",
            "telephone_number": "918-689-2508",
            "fax_number": "405-252-5632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVIEW NURSING & REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-26",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "479-899-2010"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeview Nursing & Rehab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lakeview Nursing & Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Dawn Jones
• Rachel M. Kasika, RD/LD
• Kevin G. Bradley P.C. (Professional Office of Dr Kevin G Bradley PC,Inc)
• Ki Bois Community Action Foundation (The Oaks Rehabilitative Services Center)
• George Justin Knight, MPT
• Lakeview SNF Operations LLC (Woodland Heights Nursing and Rehabilitation Center)
• Lakeview Urgent Care, P.C.
• Lisa Lakins, APRN, FNP-C
• Maisie Lanham
• Michael Laramie

• Nursing Facility/Intermediate Care Facility in Eufaula, OK
• Providers in Eufaula, 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 Jun 7, 2024; 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.

Verify at the official NPI Registry.