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Stillwater Medical Center Authority

Organization Active NPI Rural Acute Care Hospital · Perry, OK

NPI 1003318692 · NPPES record last updated Apr 1, 2025

Key facts

NPI
1003318692
Entity type
Organization (NPI type 2)
Primary specialty
Rural Acute Care Hospital 282NR1301X
Legal business name
STILLWATER MEDICAL CENTER AUTHORITY
Practice address
501 N 14TH St
Perry, OK 73077-5021
Phone
(580) 336-3541
Fax
(580) 336-7209
NPI assigned
Feb 28, 2018
Organization subpart
Yes
Parent organization (as reported)
STILLWATER MEDICAL CENTER AUTHORITY

Authorized official

Name
Denise Adrienne Webber
Title
Ceo
Phone
(405) 742-5230

Owners & managing parties with NPI records 10

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Owned or controlled facilities with NPI records 8

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Facilities with the same owner 8

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 163

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 163

Affiliated clinicians 42

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 42

Medicare Care Compare: Hospital

Listed as
Stillwater Medical - Perry CCN 370779
Type
Rural Emergency Hospital
Ownership
Government - Hospital District or Authority
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D0470011Stillwater Medical Perry
501 N 14TH Street, Perry, OK 73077		AccreditationJan 2, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OK

Hospital certification: CCN 370779

Legal name
STILLWATER MEDICAL CENTER AUTHORITY
Doing business as
STILLWATER MEDICAL PERRY
Certification status
Active
Provider type (POS)
Hospital – Rural emergency hospital
Participating since
Apr 1, 2023
Last certification
Apr 1, 2023
Beds
26
Ownership / control type
Hospital district or authority
Organization structure
Other · Non-profit
Incorporated
Jan 3, 2006 in OK
Enrollment address
501 N 14TH St
Perry, OK 73077-5021
Main/Primary Hospital Location

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Steven Taylor
Individual 		Corporate Officer Apr 1, 2018
W-2 Managing Employee Apr 1, 2018
Stillwater Medical Center Authority
Organization · Stillwater, OK
Medical provider/supplier, Non-profit 		5% Or Greater Direct Ownership Interest Apr 1, 2018 100%
Robert Lovelace
Individual 		Corporate Officer Apr 1, 2018
Courtney Kozikuski
Individual 		Corporate Officer Apr 1, 2018
W-2 Managing Employee Apr 1, 2018

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Stillwater Medical Center
Stillwater, OK · CCN 370049		 Hospital Operational/Managerial Control Oct 30, 2007
Stillwater Medical Center
Stillwater, OK · CCN 37T049		 Hospital Operational/Managerial Control Oct 30, 2007
Stillwater Medical - Blackwell
Blackwell, OK · CCN 370780		 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2020
Stillwater Medical at Home - Home Health
Stillwater, OK · CCN 377204		 Home health agency 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Oct 27, 1992
Oct 27, 1992
Stillwater Medical at Home
Stillwater, OK · CCN 371500		 Hospice 5% Or Greater Indirect Ownership Interest (100%) Jun 30, 2017
Community Medical Clinic
Perry, OK · CCN 373495		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2018
Perry Family Physicians
Perry, OK · CCN 378531		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2018
Blackwell Primary Care
Blackwell, OK · CCN 378545		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2018

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20230118000795 OK Part a Provider - Rural Emergency Hospital (Reh) 2365353794 Practice locations: Perry, OK

National Provider Directory

Part of
Cimarron Medical Supply

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X OK
Rural Acute Care Hospital 282NR1301X Yes

Addresses

Primary practice location

501 N 14TH St
Perry, OK 73077-5021

Mailing address

PO Box 23281
Belfast, ME 04915-4483
Phone (405) 533-6057

Other names

  • Perry Memorial Hospital Doing business as

Other providers in Perry, OK

All providers in Perry, OK · Rural Acute Care Hospital in Oklahoma

Sources for this page

Verify at the official NPI Registry.