EASTGATE VILLAGE LLC
NPI 1083663512
Skilled Nursing Facility in Muskogee, OK

Active since May 10, 2006CLIA 37D0880110 · Waiver
3500 HASKELL BLVD, MUSKOGEE, OK 74403(918) 682-3191(918) 682-1131 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Eastgate Village Llc NPPES

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

EASTGATE VILLAGE LLC (NPI 1083663512) is a healthcare organization registered as a skilled nursing facility in Muskogee, Oklahoma and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through December 6, 2027 and lists Mary Louise Fletcher, Administrator, as its authorized official.

NPPES Registry Identity

NPI1083663512
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameEASTGATE VILLAGE LLC
Location Address3500 HASKELL BLVDMuskogee, OK 74403-3915
Mailing Address3500 Haskell BlvdMuskogee, OK 74403-3915 · (918) 682-3191 · Fax (918) 682-1131
Fax(918) 682-1131
Organization SubpartNo
Authorized OfficialMary Louise FletcherAdministrator · (918) 682-3191
Enumeration DateMay 10, 2006
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
NPI 1083663512 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in OK · NH5113-5113
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.
Also ListedNursing Facility/Intermediate Care FacilityTaxonomy 313M00000X · License NH5113-5113 (OK)
3500 HASKELL BLVD, Muskogee, OK 74403

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 37D0880110

Eastgate Village Care & Rehab Center · Muskogee, OK
Active · expires Dec 6, 2027
CLIA Number37D0880110
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateDecember 7, 2025
Certificate Expiration DateDecember 6, 2027
Laboratory DirectorThersa J. Byfield
Laboratory Phone(918) 682-3191
Laboratory LocationEastgate Village Care & Rehab Center3500 Haskell Blvd, Muskogee, OK 74403
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 4

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

Occupational Therapy Assistant
3500 HASKELL BLVD
MUSKOGEE, OK 74403
Durable Medical Equipment & Medical Supplies
3500 HASKELL BLVD
MUSKOGEE, OK 74403
Skilled Nursing Facility
3500 HASKELL BLVD
MUSKOGEE, OK 74403
Skilled Nursing Facility
3500 HASKELL BLVD
MUSKOGEE, OK 74403

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 Eastgate Village LLC's NPI number?

The NPI number for Eastgate Village LLC is 1083663512. It was assigned to this organization in the NPPES registry on May 10, 2006.

Where is Eastgate Village LLC located?

Eastgate Village LLC is located at 3500 Haskell Blvd, Muskogee, OK 74403. The listed phone number is (918) 682-3191.

What is Eastgate Village LLC's specialty?

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

Does Eastgate Village LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 37D0880110) is associated with this NPI, valid through December 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Eastgate Village LLC accept?

Health plans from Blue Cross and Blue Shield of Oklahoma list Eastgate Village 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 Eastgate Village LLC was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.