Active NPI
University Village Retirement Community, LLC
- Skilled Nursing Facility
- Tulsa, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 7231
- Legal business name
- UNIVERSITY VILLAGE RETIREMENT COMMUNITY, LLC
- Practice address
- 8555 S Lewis Ave
Tulsa, OK 74137-1218 - Phone
- (918) 299-2661
- Fax
- (918) 298-3270
- NPI assigned
- Mar 1, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Vanessa I Neal
- Title
- Executive Director
- Phone
- (918) 299-2661
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | AL7214 | OK | |
| Skilled Nursing Facility | 314000000X | 7231 | OK | Primary |
Addresses
Primary practice location
8555 S Lewis Ave
Tulsa, OK 74137-1218
Mailing address
8555 S Lewis Ave
Tulsa, OK 74137-1218
Phone (918) 299-2661
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200424210A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111208000453 | OK | Part A Provider - Skilled Nursing Facility | 7214102953 | Practice locations: Tulsa, OK |
Skilled nursing facility certification: CCN 375531
- Legal name
- UNIVERSITY VILLAGE RETIREMENT COMMUNITY, LLC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 5, 2009
- Last certification
- Dec 5, 2024
- Beds
- 80
- Ownership / control type
- Limited Liability Corporation
- Most recent change of ownership
- Jul 29, 2011
- Organization structure
- LLC
- Incorporated
- Feb 16, 2011 in OK
- Enrollment address
- 8555 S Lewis Ave
Tulsa, OK 74137-1218 - Nursing home name
- UNIVERSITY VILLAGE RETIREMENT COMMUNITY
Care Compare: Nursing home
Medicare Care Compare- Listed as
- University Village Retirement Community
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jun 5, 2009
- Medicare certification status
- Active
- Certified beds
- 80
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 37D2198780 | University Village Retirement Community | Certificate of waiver | Nov 3, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 7
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 |
|---|---|---|---|
| Thomas C Luiskutty | Operational/Managerial Control | Oct 3, 2022 | |
| Adp of the SNF | Oct 3, 2022 | ||
| Vanessa I Neal | Operational/Managerial Control | Jul 29, 2011 | 20% |
| Adp of the SNF | Jul 29, 2011 | ||
| Keith a Roberts | 5% Or Greater Direct Ownership Interest | Jul 29, 2011 | 24% |
| Corporate Officer | Jul 29, 2011 | 24% | |
| Tammy Brown | Operational/Managerial Control | Jan 12, 2025 | |
| Adp of the SNF | Jan 12, 2025 | ||
| Blake N Fail | 5% Or Greater Direct Ownership Interest | Jul 29, 2011 | 38% |
| Corporate Officer | Jul 29, 2011 | 38% | |
| Triad Aspen Partners, LLC | Operational/Managerial Control | Aug 1, 2011 | 80% |
| Adp of the SNF | May 15, 2025 | ||
| Matthew R Gawey | 5% Or Greater Direct Ownership Interest | Jul 29, 2011 | 38% |
| Corporate Officer | Jul 29, 2011 | 38% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Tulsa, OK
- NPI 1447238654
Adp of the SNF, Operational/Managerial 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.
-
- Family Medicine Physician
- Tulsa, OK
- NPI 1811936412
-
- Internal Medicine Physician
- Tulsa, OK
- NPI 1447238654
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": "1298937600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1756252800000",
"number": "1740588672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8555 S LEWIS AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741371218",
"telephone_number": "918-299-2661",
"fax_number": "918-298-3270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8555 S LEWIS AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741371218",
"telephone_number": "918-299-2661",
"fax_number": "918-298-3270"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UNIVERSITY VILLAGE RETIREMENT COMMUNITY, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-03-01",
"last_updated": "2025-08-27",
"certification_date": "2025-08-27",
"status": "A",
"authorized_official_last_name": "NEAL",
"authorized_official_first_name": "VANESSA",
"authorized_official_middle_name": "I",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "918-299-2661"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "OK",
"license": "AL7214",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "OK",
"license": "7231",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200424210A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; 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.