Woodland Park Home, Inc.

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

NH 7232-7232 Issued in OK

Legal business name

WOODLAND PARK HOME, INC.

Practice address

5707 S Memorial Dr
Tulsa, OK 74145-9004

Phone

(918) 252-2521

NPI assigned

May 3, 2007

Last updated

May 20, 2011By 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

Mr. Ed Rucker

Title

President

Phone

(918) 743-7838

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305849600000",
    "number": "1851513063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5707 S MEMORIAL DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741459004",
            "telephone_number": "918-252-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5707 S MEMORIAL DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741459004",
            "telephone_number": "918-252-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLAND PARK HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2011-05-20",
        "status": "A",
        "authorized_official_last_name": "RUCKER",
        "authorized_official_first_name": "ED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-743-7838",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "OK",
            "license": "NH 7232-7232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200114440A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Woodbury
• Yvonne Christine Woodfin
• Woodland Dentistry and Braces
• Woodland Health Inc (Smith Chiropractic)
• Woodland Park Home Management Company, L.L.C.
• Kimberly Woodmansee
• Conchita L Woodruff, M.D.
• Kate Madelyn Woods-Hiserodt
• Amanda Danielle Woods-Roberts
• Amy Lynn Woods, COTA/L

• Intellectual Disabilities Intermediate Care Facility in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Intellectual Disabilities Intermediate Care Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2011; 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.