Spanish Cove Housing Authority

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

CC0901-0901 Issued in OK

Legal business name

SPANISH COVE HOUSING AUTHORITY

Practice address

11 Palm Ave
Yukon, OK 73099-5645

Phone

(405) 354-1901

Fax

(405) 354-6584

NPI assigned

Apr 5, 2013

Organization subpart

No

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

Authorized official

Name

Donald N. Blose

Title

Ceo & Executive Administrator

Phone

(405) 354-1901

Specialties & licenses 3

Addresses

Other names 1

• Spanish Cove Retirement Village Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Skilled nursing facility certification: CCN 375560

Legal name

SPANISH COVE HOUSING AUTHORITY

Doing business as

SPANISH COVE RETIREMENT VILLAGE

Certification status

Active

Provider type (POS)

Nursing home – SNF (Medicare) only

Participating since

Mar 7, 2014

Last certification

Oct 23, 2024

Beds

57

Ownership / control type

Individual

Organization structure

OtherNon-profit

Incorporated

Apr 28, 1998 in OK

Enrollment address

11 Palm Ave
Yukon, OK 73099-5645

Nursing home name

SPANISH COVE HOUSING AUTHORITY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Spanish Cove Housing Authority

  • Home Health Agency
  • Yukon, OK
  • NPI 1851789069

  0446499107

  Same PAC ID

Listed as

Spanish Cove Housing AuthorityCCN 375560

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

4 of 5

Quality measures

3 of 5

Type

Medicare

Ownership

For profit - Individual

Certified

Mar 7, 2014

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

5753.8 residents per day on average

Penalties (3 years)

2Fines totaling $8,018

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Spanish Cove Housing Authority3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Spanish Cove Housing Authority

  • Adult Care Home Facility
  • Yukon, OK
  • NPI 1841577905
  NPD tax ID
• Spanish Cove Housing Authority

  • Home Health Agency
  • Yukon, OK
  • NPI 1851789069
  NPD tax ID

All disclosed owners & managing parties 19

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 2

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

• James B Krablin, MD

  • Internal Medicine Physician
  • Lexington, OK
  • NPI 1679509657

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Spanish Cove Housing Authority

  • Home Health Agency
  • Yukon, OK
  • NPI 1851789069

  5% Or Greater Direct Ownership Interest, Adp of the SNF

  CMS ownership

Affiliated clinicians 3

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

• Curtis L Brown, M.D.

  • Family Medicine Physician
  • Yukon, OK
  • NPI 1467469288

  Nursing home

  Care Compare affiliation
• Layne Keathly, M.D.

  • Family Medicine Physician
  • Yukon, OK
  • NPI 1760802177

  Nursing home

  Care Compare affiliation
• James B Krablin, MD

  • Internal Medicine Physician
  • Lexington, OK
  • NPI 1679509657

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1365120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728864000000",
    "number": "1982947172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 PALM AVE",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730995645",
            "telephone_number": "405-354-1901",
            "fax_number": "405-354-6584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 PALM AVE",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730995645",
            "telephone_number": "405-354-1901",
            "fax_number": "405-354-6584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPANISH COVE HOUSING AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-05",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A",
        "authorized_official_last_name": "BLOSE",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "CEO & EXECUTIVE ADMINISTRATOR",
        "authorized_official_telephone_number": "405-354-1901"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OK",
            "license": "CC0901-0901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spanish Cove Retirement Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Casey Snodgrass
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• Spanish Cove Housing Authority
• Spanish Cove Housing Authority
• Kelly Sparks, MACCCSLP
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• Cristy Spencer
• SSM Healthcare of Oklahoma, Inc

• Skilled Nursing Facility in Yukon, OK
• Providers in Yukon, 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 Oct 14, 2024; 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.