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NORTHSIDE NURSING HOME
NPI 1629001409
Nursing Facility/Intermediate Care Facility in Sapulpa, OK

Active since July 07, 2006
102 E LINE AVE, SAPULPA, OK 74066(918) 224-0833(918) 227-2405 Get Directions Write a Review

NPPES record last updated: November 15, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Northside Nursing Home NPPES

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

NORTHSIDE NURSING HOME (NPI 1629001409) is a healthcare organization registered as a nursing facility/intermediate care facility in Sapulpa, Oklahoma and active in the NPI registry since July 2006. The organization lists Ernest M Johnson, Administrator/managing Member, as its authorized official.

NPPES Registry Identity

NPI1629001409
Entity TypeOrganization
Primary Taxonomy313M00000X
Legal Business NameD E K MANAGEMENT LLC
Location Address102 E LINE AVESapulpa, OK 74066-2858
Mailing Address10842 S 137th West AveSapulpa, OK 74066-6737 · (918) 224-0833 · Fax (918) 227-2405
Phone(918) 224-0833
Fax(918) 227-2405
Organization SubpartNo
Authorized OfficialErnest M JohnsonAdministrator/managing Member · (918) 224-0833
Enumeration DateJuly 7, 2006
Last NPPES UpdateNovember 15, 2012
✔ NPI 1629001409 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
Taxonomy Code313M00000X
License✔ Licensed in OK · NH1902-1902
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
102 E LINE AVE, Sapulpa, OK 74066
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Other Names 1

Doing Business AsNorthside Nursing Home

Other Identifiers 2

Medicaid200044850AOK
Medicare OSCAR/certification375523

Other Providers at the Same Location NPPES 2

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

BEACON RIDGE SNF OPERATIONS LLC
Skilled Nursing Facility
102 E LINE AVE
SAPULPA, OK 74066
Creek County (918) 216-1811
CITY OF SAPULPA
Skilled Nursing Facility
102 E LINE AVE
SAPULPA, OK 74066
Creek County (918) 216-1811

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 D E K Management LLC's NPI number?

The NPI number for D E K Management LLC is 1629001409. It was assigned to this organization in the NPPES registry on July 7, 2006. The provider is doing business as Northside Nursing Home.

Where is D E K Management LLC located?

D E K Management LLC is located at 102 E Line Ave, Sapulpa, OK 74066. The listed phone number is (918) 224-0833.

What is D E K Management LLC's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

When was this NPI record last updated?

The NPPES record for D E K Management LLC was last updated on November 15, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years 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.