NPIMap

Organization Active NPI

Altus Operations L L C

  • Skilled Nursing Facility
  • Altus, OK
National Provider Identifier
1992810410
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
PENDING Issued in OK
Legal business name
ALTUS OPERATIONS L L C
Practice address
2610 Cedar Creek Dr
Altus, OK 73521-1312
Phone
(580) 480-1800
Fax
(580) 477-2006
NPI assigned
Aug 21, 2006
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 PENDING OK Primary

Addresses

Primary practice location

2610 Cedar Creek Dr
Altus, OK 73521-1312

Mailing address

2610 Cedar Creek Dr
Altus, OK 73521-1312
Phone (580) 480-1800

Other identifiers 1

IdentifierTypeStateIssuer
100778080AMedicaidOK

Other names 2

  • Magnolia Creek Skilled Nursing and Therapy Doing business as
  • PLANTATION VILLAGE 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
O20061219000508 OK Part A Provider - Skilled Nursing Facility 8123031515 Practice locations: Altus, OK

Skilled nursing facility certification: CCN 375505

Legal name
ALTUS OPERATIONS, L L C
Doing business as
MAGNOLIA CREEK SKILLED NURSING AND THERAPY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 13, 2006
Last certification
Jun 21, 2024
Beds
158
Ownership / control type
Partnership
Organization structure
LLCProprietary
Incorporated
May 5, 2006 in OK
Enrollment address
2610 Cedar Creek Drive
Altus, OK 73521-1312
Nursing home name
MAGNOLIA CREEK SKILLED NURSING AND THERAPY
Affiliated entity
BRIDGES HEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
Magnolia Creek Skilled Nursing and TherapyCCN 375505
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
Oct 13, 2006
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
15879.7 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
37D1067512Magnolia Creek Skilled Nursing and Therapy2610 Cedar Creek Dr, Altus, OK 73521Certificate of waiverApr 18, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 16

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 Operational/Managerial Control Jan 1, 2021
Adp of the SNF Jan 1, 2021
Bridges Esop, Inc Organization, Oklahoma City, OK Created for acquisition, Corporation, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 31, 2020 100%
Orix Real Estate Capital LLC Organization, Dallas, TX LLC 5% Or Greater Mortgage Interest May 1, 2023 65%
FLP, L.L.C. Organization, Oklahoma City, OK LLC Adp of the SNF Dec 3, 2025
Bridges Employee Stock Ownership Trust Organization, Lisle, IL Created for acquisition 5% Or Greater Indirect Ownership Interest Dec 31, 2020 100%
William Griffin Individual Corporate DirectorDirector Jan 1, 2021 100%
Adp of the SNF Jan 1, 2021
Altus Real Estate, LLC Organization, Oklahoma City, OK LLC Adp of the SNF Jun 30, 2006
Michael a Boone Individual Managing Control - Governing BodyRegional Manager Jan 1, 2021
Adp of the SNF Jan 1, 2021
William Brett Coble Individual Corporate OfficerPresident/Manager Apr 1, 2020 100%
Adp of the SNF Jan 1, 2021
Julie St John Mahaney Individual Operational/Managerial Control Jul 1, 2024
Adp of the SNF Jul 1, 2024
Karen K Baker Individual Adp of the SNF Aug 4, 2025
Amity Care, LLC Organization, Oklahoma City, OK LLC, Chain home office Adp of the SNF Nov 25, 2025
Dennis Long Individual Adp of the SNF Jan 1, 2021
Robert Duncan Individual Adp of the SNF Dec 13, 2022
Renew Properties, LLC Organization, Oklahoma City, OK LLC Adp of the SNF Apr 30, 2026
Kenneth D. Greiner III Revocable Trust Organization, Oklahoma City, OK 5% Or Greater Security Interest Dec 31, 2020 19.9%

Owners & managing parties with NPI records 1

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

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 4

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

Affiliated clinicians 3

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

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770249600000",
    "number": "1992810410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 CEDAR CREEK DR",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735211312",
            "telephone_number": "580-480-1800",
            "fax_number": "580-477-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 CEDAR CREEK DR",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735211312",
            "telephone_number": "580-480-1800",
            "fax_number": "580-477-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTUS OPERATIONS L L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "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": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100778080A",
            "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": "64 S Price Rd",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Magnolia Creek Skilled Nursing and Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PLANTATION VILLAGE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PLANTATION VILLAGE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Altus, OK

Sources for this page

Verify at the official NPI Registry.