Oak Lake, LLC
NPI 1154628790 · Skilled Nursing Facility · Grove, OK
Enrolled with Medicare as Part a Provider - Skilled Nursing Facility · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Oak Lake, LLC is a Skilled Nursing Facility organization in Grove, OK (NPI 1154628790).
Provider details
- NPI number
- 1154628790
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Chris Brogdon, Manager(770) 650-8793
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Grand Lake Villa
- Doing business as
- Grand Lake Villa
Registry dates
- Enumerated
- 2011-02-17
- Last updated
- 2022-01-19
- Certified
- 2022-01-19
Frequently asked questions
- What is Oak Lake, LLC's NPI number?
- Oak Lake, LLC's National Provider Identifier (NPI) is 1154628790, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Oak Lake, LLC?
- Oak Lake, LLC is classified in the NPPES registry as Skilled Nursing Facility (Nursing & Custodial Care Facilities).
- Where is Oak Lake, LLC located?
- Oak Lake, LLC's practice location on file with NPPES is 103 Har-Ber Rd, Grove, OK 74345-0547.
- What is Oak Lake, LLC's phone number?
- The practice phone number listed in the NPPES registry for Oak Lake, LLC is (918) 786-2276.
- Does Oak Lake, LLC accept Medicare?
- Oak Lake, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Oak Lake, LLC?
- The authorized official listed on Oak Lake, LLC's NPPES record is Chris Brogdon, Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Oak Lake, LLC's NPI active?
- Yes — Oak Lake, LLC's NPI (1154628790) is active in the NPPES registry as of the last update on 2022-01-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.