Hominy Community Medical Trust Authority

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

EMS421 Issued in OK

Legal business name

HOMINY COMMUNITY MEDICAL TRUST AUTHORITY

Practice address

505 N. Eastern
Hominy, OK 74035-1034

Phone

(800) 538-8278

Fax

(580) 628-2273

NPI assigned

Oct 18, 2006

Last updated

Oct 12, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brett Whitten

Title

EMS Director

Phone

(800) 538-8278

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350000000000",
    "number": "1003997628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98",
            "city": "HOMINY",
            "state": "OK",
            "postal_code": "740350098",
            "telephone_number": "800-538-8278",
            "fax_number": "580-628-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N. EASTERN",
            "city": "HOMINY",
            "state": "OK",
            "postal_code": "740351034",
            "telephone_number": "800-538-8278",
            "fax_number": "580-628-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMINY COMMUNITY MEDICAL TRUST AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2012-10-12",
        "status": "A",
        "authorized_official_last_name": "WHITTEN",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "EMS DIRECTOR",
        "authorized_official_telephone_number": "800-538-8278"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "OK",
            "license": "EMS421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100699680B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harmony Dunning, M.ED, LPC, RPT, NCC
• Fairfax Medical Facilities Inc (Hominy Family Health Center)
• Kisha Marie Farrell, APRN FNP-BC
• Katelyn S Fitzgerald, APRN, FNP-C
• Heel to Toe Foot Care Plus Inc
• Hominy Public School
• Hominy Rexall Inc (Hominy Rexall Drug)
• Mary Kekahbah
• Wendy Denise Madison, CNP
• Timothy William Mauer

• Land Ambulance in Hominy, OK
• Providers in Hominy, OK by specialty
• Land Ambulance in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.