Arbor Village Nursing, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH1902 Issued in OK

Legal business name

ARBOR VILLAGE NURSING, LLC

Doing business as

Northside Nursing Home

Practice address

3325 French Park Dr
Suite 6
Edmond, OK 73034-7277

Phone

(405) 285-8166

Fax

(405) 563-9447

NPI assigned

May 27, 2014

Last updated

Jun 5, 2020By 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

Scott Pilgrim

Title

Member

Phone

(405) 285-8166

Specialties & licenses 1

Addresses

Other names 1

• Northside Nursing Home Doing business as

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

{
    "created_epoch": "1401148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591315200000",
    "number": "1790197747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 E LINE AVE",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740662858",
            "telephone_number": "918-224-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 FRENCH PARK DR",
            "address_2": "SUITE 6",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730347277",
            "telephone_number": "405-285-8166",
            "fax_number": "405-563-9447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARBOR VILLAGE NURSING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-27",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A",
        "authorized_official_last_name": "PILGRIM",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "405-285-8166"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OK",
            "license": "NH1902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northside Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Edmond, OK
• Providers in Edmond, OK by specialty
• Skilled Nursing Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.