NPIMap

Organization Active NPI

Farmers Union Hospital Association

Doing business as Great Plains Medical Clinic

  • Rural Health Clinic/Center
  • Elk City, OK
National Provider Identifier
1023512308
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
FARMERS UNION HOSPITAL ASSOCIATION
Doing business as
Great Plains Medical Clinic
Practice address
1901 W 3Rd St Ste a
Elk City, OK 73644-4340
Phone
(580) 225-2513
Fax
(580) 303-5863
NPI assigned
Mar 21, 2018
Last updated
Jul 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Authorized official

Name
Corey Lively
Title
Ceo
Phone
(580) 821-5300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

1901 W 3Rd St Ste a
Elk City, OK 73644-4340

Mailing address

PO Box 2339
Elk City, OK 73648-2339
Phone (580) 225-2511

Other names 1

  • Great Plains Medical Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080616000473 OK Part A Provider - Hospital 7517949415 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clinton, OK; Elk City, OK
O20180626000506 OK Part A Provider - Rural Health Clinic 7517949415 Practice locations: Elk City, OK

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1023512308. Details of each certification follow.

Hospital certification: CCN 370019

Legal name
FARMERS UNION HOSPITAL ASSOCIATION
Doing business as
GREAT PLAINS REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Apr 17, 2023
Beds
62
Ownership / control type
Private (not for profit)
Organization structure
OtherNon-profit
Incorporated
Aug 30, 1938 in OK
Enrollment address
404 S Eastern Ave
Elk City, OK 73644-9608
Other Hospital Practice Location
Hospital subgroups
Acute care

Rural health clinic certification: CCN 378524

Legal name
FARMERS UNION HOSPITAL ASSOCIATION
Doing business as
GREAT PLAINS REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 12, 2019
Last certification
Mar 1, 2022
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Aug 30, 1938 in OK
Enrollment address
1901 W 3Rd St
Ste a
Elk City, OK 73644-4340
Related CCNs
370019

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Great Plains Regional Medical CenterCCN 370019 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2080408Great Plains Medical Clinic1901 W 3Rd St, Suite a, Elk City, OK 73644Certificate of waiverJul 6, 2028
37D2098512Great Plains Medical Clinic1901 W 3Rd St, Ste a, Elk City, OK 73644Certificate of waiverNov 7, 2027

National Provider Directory

National Provider Directory
Tax ID family
Kathryn a Trissellmd8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Paul Kumpf Individual Corporate Director Oct 1, 1993
Corporate DirectorDirector Oct 1, 1993
Edward Albert Individual Corporate Director Oct 1, 2002
Corporate DirectorDirector Oct 1, 2002
Jeff Jackson Individual Corporate Director Oct 1, 2016
Corporate DirectorDirector Oct 1, 2016
Kyle Zybach Individual Corporate Director Jan 1, 2018
Corporate DirectorDirector Jan 1, 2018
Monica R Scott Individual W-2 Managing EmployeeCfo Aug 19, 2013
Corporate OfficerChief Financial Officer Aug 19, 2013 50%
W-2 Managing EmployeeChief Financial Officer Aug 19, 2013 50%
Danny Sprowls Individual Corporate Director Oct 1, 2003
Corporate DirectorDirector Oct 1, 2003
Joe Allen Individual Corporate DirectorVice-Chairman Nov 4, 2022
Corporate Director Nov 4, 2022
Tyson D Fisher Individual Corporate DirectorVice Chief of Staff Nov 1, 2022
Corporate Director Mar 6, 2019
Farmers Union Hospital Association Organization, Elk City, OK Operational/Managerial Control Feb 14, 2014
Erick C Derocher Individual Corporate Director Nov 1, 2016
Corporate DirectorDirector Nov 1, 2016
Daniel Garbarino Individual Corporate DirectorBoard Member Dec 1, 2022
Corporate Director Jan 1, 2024
Corey Lively Individual Corporate OfficerCeo Feb 3, 2014 100%
Corporate OfficerChief Executive Officer Feb 3, 2014 50%
W-2 Managing EmployeeChief Executive Officer Feb 3, 2014 50%
J C Coffey Individual Corporate Director Oct 1, 2011
Corporate DirectorDirector Oct 1, 2011

Owners & managing parties with NPI records 9

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Great Plains Regional Medical CenterElk City, OK, CCN 370019 Hospital Operational/Managerial Control Feb 14, 2014
Great Plains Regional Medical CenterElk City, OK, CCN 37T019 Hospital Operational/Managerial Control Feb 14, 2014

Owned or controlled facilities with NPI records 3

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

Practitioners & affiliated clinicians

Affiliated clinicians 136

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

View all 136

NPI Registry JSON

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753833600000",
    "number": "1023512308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2339",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736482339",
            "telephone_number": "580-225-2511",
            "fax_number": "580-225-9143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W 3RD ST STE A",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736444340",
            "telephone_number": "580-225-2513",
            "fax_number": "580-303-5863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARMERS UNION HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-21",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A",
        "authorized_official_last_name": "LIVELY",
        "authorized_official_first_name": "COREY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "580-821-5300"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Plains Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Great Plains Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elk City, OK

Sources for this page

Verify at the official NPI Registry.