PSG - Willow Park LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

NH1607-1607 Issued in OK

Legal business name

PSG - WILLOW PARK LLC

Practice address

7019 NW Cache Rd
Lawton, OK 73505-2707

Phone

(580) 536-1279

Fax

(580) 510-0017

NPI assigned

Jun 21, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Cheryl Hankins

Title

Administrator

Phone

(580) 536-1279

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Jacqueline Ann Yarbrough, FNP- C

  • Nurse Practitioner
  • Oklahoma City, OK
  • NPI 1124536388
  NPD (past)

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1821093352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7019 NW CACHE RD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735052707",
            "telephone_number": "580-536-1279",
            "fax_number": "580-510-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7019 NW CACHE RD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735052707",
            "telephone_number": "580-536-1279",
            "fax_number": "580-510-0017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSG - WILLOW PARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-21",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "HANKINS",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "580-536-1279",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "OK",
            "license": "NH1607-1607",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OK",
            "license": "NH 16071607",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Aubrey Spyce Pruitt, MS, LPC CANDIDATE
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• Cydney Puczek, RBT
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• Bradden Rex Pyron, M.D.

• Nursing Facility/Intermediate Care Facility in Lawton, OK
• Providers in Lawton, 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 Sep 11, 2025; 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.