Epworth Villa – Nursing Facility/Intermediate Care Facility, NPI 1114922598

Epworth Villa is a healthcare provider. based in Oklahoma city, Oklahoma. specializing in Nursing Facility/Intermediate Care Facility. The organization holds a License No. CC5504 (OK). The NPI Number for Epworth Villa is 1114922598

Main info

Organization
Name
Epworth Villa
NPI
1114922598
Phone
(405) 752-1200
Address
14901 N PENNSYLVANIA AVE
Authorized Official
KENNETH LEE BULLOCK CFO
Enumeration Date
14 June 2005
Last Update Date
8 July 2019
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness80
Years active:20State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Epworth Villa

  • North Pennsylvania Avenue, Oklahoma City, Oklahoma County, Oklahoma, 73003, United States

    OKLAHOMA CITY, OK 731346069

    Phone: (405) 752-1200

    Fax: (405) 755-5106

    Type: Mailing

  • 14901, North Pennsylvania Avenue, Oklahoma City, Oklahoma County, Oklahoma, 73134, United States

    OKLAHOMA CITY, OK 73134

    Phone: (405) 752-1200

    Fax: (405) 755-5106

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-09-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20040909000976OSkilled Nursing FacilityOKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 73134)

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Reviews

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Frequently asked questions

What number should I use to identify Epworth Villa for billing?
Administrative and clinical systems typically use NPI 1114922598 for Epworth Villa.
Should I treat Epworth Villa as an active provider?
Patients and plans typically see Epworth Villa as active in the national extract.
Which specialty label fits Epworth Villa?
NPPES ties Epworth Villa to Nursing Facility/Intermediate Care Facility in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is Epworth Villa tied to Oklahoma City, Oklahoma?
If you are local to Oklahoma City, Oklahoma, Epworth Villa may be relevant to your search.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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