NPIMap

Organization Active NPI

Western Nursing Home LLC

Doing business as Grace Living Center - Buffalo

  • Skilled Nursing Facility
  • Buffalo, OK
National Provider Identifier
1821182270
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH3001-3001 Issued in OK
Legal business name
WESTERN NURSING HOME LLC
Doing business as
Grace Living Center - Buffalo
Western Skilled Nursing and Therapy
Practice address
111 Walnut Dr
Buffalo, OK 73834
Phone
(580) 735-2415
Fax
(580) 735-2165
NPI assigned
Oct 2, 2006
Last updated
Feb 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

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

Authorized official

Name
Kristy Deroin
Title
Director of RCM
Phone
(405) 943-1144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH3001-3001 OK Primary

Addresses

Primary practice location

111 Walnut Dr
Buffalo, OK 73834

Mailing address

111 Walnut Dr
Buffalo, OK 73834-8832
Phone (580) 735-2415

Other identifiers 1

IdentifierTypeStateIssuer
100810460BMedicaidOK

Other names 2

  • GRACE LIVING CENTER - BUFFALO Doing business as
  • Western Skilled Nursing and Therapy Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031222000077 OK Part A Provider - Skilled Nursing Facility 2961309935 Practice locations: Buffalo, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821182270. Details of each certification follow.

Skilled nursing facility certification: CCN 375259

Legal name
WESTERN NURSING HOME LLC
Doing business as
WESTERN SKILLED NURSING AND THERAPY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 1, 1996
Last certification
Nov 21, 2024
Beds
76
Ownership / control type
Partnership
Organization structure
LLCProprietary
Enrollment address
111 Walnut Dr
Buffalo, OK 73834-0001
Nursing home name
WESTERN SKILLED NURSING AND THERAPY
Affiliated entity
BRIDGES HEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
Western Skilled Nursing and TherapyCCN 375259 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
May 1, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7627.7 residents per day on average
Chain
Bridges Health33 facilities in the chain

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
37D0472774Western Skilled Nursing and Therapy111 Walnut Drive, Buffalo, OK 73834Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Kristy Deroin Individual W-2 Managing EmployeeDirector of Reimbursement Dec 31, 2020
Bridges Esop, Inc Organization, Oklahoma City, OK Corporation 5% Or Greater Direct Ownership Interest Dec 31, 2020 100%
Operational/Managerial Control Dec 31, 2020 100%
Bridges Employee Stock Ownership Trust Organization, Lisle, IL Created for acquisition 5% Or Greater Indirect Ownership Interest Dec 31, 2020 100%
William Brett Coble Individual Corporate OfficerPresident/Manager Dec 31, 2020
Operational/Managerial ControlPresident/Manager Dec 31, 2020

Facilities with the same owner 33

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

View all 33

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770249600000",
    "number": "1821182270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WALNUT DR",
            "city": "BUFFALO",
            "state": "OK",
            "postal_code": "738348832",
            "telephone_number": "580-735-2415",
            "fax_number": "580-735-2165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WALNUT DR",
            "city": "BUFFALO",
            "state": "OK",
            "postal_code": "73834",
            "telephone_number": "580-735-2415",
            "fax_number": "580-735-2165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN NURSING HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A",
        "authorized_official_last_name": "DEROIN",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "DIRECTOR OF RCM",
        "authorized_official_telephone_number": "405-943-1144"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OK",
            "license": "NH3001-3001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100810460B",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "111 WALNUT DR",
            "city": "BUFFALO",
            "state": "OK",
            "country_code": "US",
            "postal_code": "73834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "GRACE LIVING CENTER - BUFFALO",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Western Skilled Nursing and Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Buffalo, OK

Sources for this page

Verify at the official NPI Registry.