PERRY GREEN VALLEY NURSING HOME LLC
NPI 1003027921
Skilled Nursing Facility in Perry, OK

Active since May 24, 2007CLIA 37D0712853 · Waiver
1103 BIRCH ST, PERRY, OK 73077(580) 336-2285(580) 336-3445 Get Directions Write a Review

NPPES record last updated: April 19, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Perry Green Valley Nursing Home Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PERRY GREEN VALLEY NURSING HOME LLC (NPI 1003027921) is a healthcare organization registered as a skilled nursing facility in Perry, Oklahoma and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Tandie Hastings, Sole Member, as its authorized official.

NPPES Registry Identity

NPI1003027921
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NamePERRY GREEN VALLEY NURSING HOME LLC
Location Address1103 BIRCH STPerry, OK 73077-6269
Mailing AddressPo Box 1095Guthrie, OK 73044-1095 · (405) 282-6285 · Fax (405) 282-5731
Fax(580) 336-3445
Organization SubpartNo
Authorized OfficialTandie HastingsSole Member · (405) 282-6285
Enumeration DateMay 24, 2007
Last NPPES UpdateApril 19, 2012
NPI 1003027921 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in OK · NH5202
Definition

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

1103 BIRCH ST, Perry, OK 73077

Other Identifiers 2

Medicaid200114510AOK
Medicare OSCAR/certification375373

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 37D0712853

Perry Green Valley Nursing Home, LLC · Perry, OK
Active · expires Aug 31, 2026
CLIA Number37D0712853
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorJody Sim
Laboratory Phone(580) 336-2285
Laboratory LocationPerry Green Valley Nursing Home, LLC1103 Birch St, Perry, OK 73077
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Skilled Nursing Facility
1103 BIRCH ST
PERRY, OK 73077

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Perry Green Valley Nursing Home LLC's NPI number?

The NPI number for Perry Green Valley Nursing Home LLC is 1003027921. It was assigned to this organization in the NPPES registry on May 24, 2007.

Where is Perry Green Valley Nursing Home LLC located?

Perry Green Valley Nursing Home LLC is located at 1103 Birch St, Perry, OK 73077. The listed phone number is (580) 336-2285.

What is Perry Green Valley Nursing Home LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Perry Green Valley Nursing Home LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 37D0712853) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Perry Green Valley Nursing Home LLC accept?

Health plans from Blue Cross and Blue Shield of Oklahoma list Perry Green Valley Nursing Home LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Perry Green Valley Nursing Home LLC was last updated on April 19, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.