Ignite Medical Resort Tulsa, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

IGNITE MEDICAL RESORT TULSA, LLC

Practice address

8720 S 101St East Ave
Tulsa, OK 74133-5840

Phone

(918) 965-0101

NPI assigned

Jan 20, 2025

Last updated

Jan 20, 2025By 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

Timothy Fields

Title

Manager

Phone

(630) 327-2951

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891507620. Details of each certification follow.

• CCN 375581 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 375581

Legal name

IGNITE MEDICAL RESORT TULSA, LLC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Aug 17, 2021

Last certification

Dec 11, 2024

Beds

104

Ownership / control type

Limited Liability Corporation

Organization structure

LLCProprietary

Enrollment address

8720 S 101St East Ave
Tulsa, OK 74133-5840

Nursing home name

IGNITE MEDICAL RESORT TULSA, LLC

Affiliated entity

IGNITE MEDICAL RESORTS

Listed as

Ignite Medical Resort Tulsa, LLCCCN 375581 · All quality measures

Overall star rating

5 of 5

Health inspections

4 of 5

Staffing

3 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Aug 17, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

10497.7 residents per day on average

Chain

Ignite Medical Resorts22 facilities in the chain

Penalties (3 years)

1Fines totaling $16,772

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 33

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Ryan J Reynolds, D.O.

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1114459278

  Adp of the SNF

  CMS ownership

Facilities with the same owner 22

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

• Ignite Medical Resort Bartlesville, LLC

  • Skilled Nursing Facility
  • Bartlesville, OK
  • NPI 1023648383

  Ignite Team Partners LLC, Spark Therapy LLC

  CMS ownership
• Ignite Medical Resort Norman, LLC

  • Skilled Nursing Facility
  • Norman, OK
  • NPI 1689204943

  Ignite Team Partners LLC, Spark Therapy LLC

  CMS ownership
• Ignite Medical Resort Okc, LLC

  • Skilled Nursing Facility
  • Oklahoma City, OK
  • NPI 1316577679

  Ignite Team Partners LLC, Spark Therapy LLC

  CMS ownership
• Ignite Medical Batavia, LLC

  • Skilled Nursing Facility
  • Batavia, IL
  • NPI 1942197686

  Ignite Team Partners LLC

  CMS ownership
• Ignite Medical Hanover Park, LLC

  • Skilled Nursing Facility
  • Hanover Park, IL
  • NPI 1932899689

  Blue Pearl Financial LLC, Ignite Post Acute Solutions LLC, Ignite Team Partners LLC, Spark Therapy LLC

  CMS ownership
• Ignite Medical Resort Carondelet, LLC

  • Skilled Nursing Facility
  • Kansas City, MO
  • NPI 1649808577

  Blue Pearl Financial LLC, Ignite Post Acute Solutions LLC, Ignite Team Partners LLC, Spark Therapy LLC

  CMS ownership
• Ignite Medical Resort Chesterton LLC

  • Skilled Nursing Facility
  • Chesterton, IN
  • NPI 1326895053

  Ignite Team Partners LLC

  CMS ownership
• Ignite Medical Resort Crown Point, LLC

  • Skilled Nursing Facility
  • Crown Point, IN
  • NPI 1801672977

  Ignite Team Partners LLC, Spark Therapy LLC

  CMS ownership
• Ignite Medical Resort Dyer, LLC

  • Skilled Nursing Facility
  • Dyer, IN
  • NPI 1427834597

  Blue Pearl Financial LLC, Ignite Post Acute Solutions LLC, Ignite Team Partners LLC, Spark Therapy LLC

  CMS ownership
• Ignite Medical Resort El Paso, LLC

  • Skilled Nursing Facility
  • El Paso, TX
  • NPI 1083434336

  Blue Pearl Financial LLC, Ignite Post Acute Solutions LLC, Ignite Team Partners LLC

  CMS ownership
• Ignite Medical Resort Fort Worth, LLC

  • Skilled Nursing Facility
  • Fort Worth, TX
  • NPI 1659031268

  Ignite Team Partners LLC, Spark Therapy LLC

  CMS ownership
• Ignite Medical Resort Independence LLC

  dba Ignite Medical Resort Blue Springs

  • Skilled Nursing Facility
  • Blue Springs, MO
  • NPI 1609492719

  Blue Pearl Financial LLC, Ignite Post Acute Solutions LLC, Ignite Team Partners LLC, Spark Therapy LLC

  CMS ownership

Practitioners 1

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.

• Joseph Michael Moore, MD

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1104853142
  NPD (past)

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Bryce Alexander Armstrong, DO

  • Internal Medicine Physician
  • Jenks, OK
  • NPI 1629640768

  Nursing home

  Care Compare affiliation
• Joseph Michael Moore, MD

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1104853142

  Nursing home

  Care Compare affiliation
• Ryan J Reynolds, D.O.

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1114459278

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1737331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737331200000",
    "number": "1891507620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 N NORTHWEST HWY STE 430",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681461",
            "telephone_number": "847-453-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8720 S 101ST EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335840",
            "telephone_number": "918-965-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IGNITE MEDICAL RESORT TULSA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-20",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A",
        "authorized_official_last_name": "FIELDS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "630-327-2951"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mutasim Mohamed Eltigani Idriss, MD
• Ies ER Oklahoma LLC
• Fidelis Ifeanyi Ariguzo, RPH
• Crystal Ifekoya
• Philida Rosalind Ignacio
• Nikki Lauren Igo, DO
• Stephanie Igtiben, MD
• Timothy George Ihrig, MD
• Shannon Denise Ijams, PA-C
• Shahnawaz Chaudhry Ijaz

• Skilled Nursing Facility in Tulsa, OK
• Providers in Tulsa, 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 Jan 20, 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.

Verify at the official NPI Registry.