PADDINGTON PLACE LLC NPI 1043834849

NPI Information

NPI: 1043834849
Provider Name: PADDINGTON PLACE, LLC
Classification: Intermediate Care Facility, Mental Illness - 310500000X
Entity Type: Organization
Doing Business As: PADDINGTON PLACE COTTAGES 1-4
CLIA Number: 37D2288096
Address: 76 RACHEL STREET
BIXBY, OK
ZIP 74008
Phone: (918) 290-3401

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NPI Details

PADDINGTON PLACE, LLC is an intermediate care facility mental illness in Bixby, OK. The provider is a nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. PADDINGTON PLACE, LLC NPI is 1043834849. The provider is registered as an organization entity type.
The provider Is Doing Business As Paddington Place Cottages 1-4.

The provider's business location address is:

76 RACHEL STREET
BIXBY, OK
ZIP 74008
Phone: (918) 290-3401
Fax: (539) 302-9786

The provider's authorized official is Scott D Pilgrim .
The authorized official title is Managing Member and has the following contact phone number (405) 285-8166.

The CLIA number assigned to this NPI record is 37D2288096 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/8/2020 and was last updated on 8/15/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	310500000X	Intermediate Care Facility, Mental Illness				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	201013670A	MEDICAID	OKLAHOMA
2	201013680A	MEDICAID	OKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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