NPIMap

Organization Active NPI

Fairview Regional Medical Center Authority

Doing business as Fairview Regional Medical Center

  • Critical Access Hospital
  • Fairview, OK
National Provider Identifier
1033153309
Registry record updated Oct 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
2248 Issued in OK
Legal business name
FAIRVIEW REGIONAL MEDICAL CENTER AUTHORITY
Doing business as
Fairview Regional Medical Center
Practice address
523 E State Rd
Fairview, OK 73737-1453
Phone
(580) 227-3721
Fax
(580) 227-2882
NPI assigned
Jun 16, 2006
Last updated
Oct 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2016

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

Authorized official

Name
Roger Knak
Title
Administrator
Phone
(580) 227-3721

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 2248 OK Primary

Addresses

Primary practice location

523 E State Rd
Fairview, OK 73737-1453

Mailing address

PO Box 548
Fairview, OK 73737-0548
Phone (580) 227-3721

Other identifiers 1

IdentifierTypeStateIssuer
100700800AMedicaidOK

Other names 1

  • Fairview Regional Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150424001440 OK Part A Provider - Critical Access Hospital 4183943186 Receives reassigned benefits from 9 practitioners
Practice locations: Fairview, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033153309. Details of each certification follow.

Hospital certification: CCN 371329

Legal name
FAIRVIEW REGIONAL MEDICAL CENTER AUTHORITY
Doing business as
FAIRVIEW REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jan 1, 2005
Last certification
Mar 13, 2026
Beds
25
Ownership / control type
Hospital district or authority
Organization structure
CorporationNon-profit
Incorporated
Apr 20, 2022 in OK
Enrollment address
523 State Road
Fairview Regional Medical Center
Fairview, OK 73737-1453
Main/Primary Hospital Location

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

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Fairview Regional Medical Center AuthorityCCN 371329 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Fairview Reg Med Ctr Auth2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Wilinda Harmon Individual Corporate DirectorBoard Member Jan 1, 2015
Fairview Regional Medical Center Authority Organization, Fairview, OK Medical provider/supplier 5% Or Greater Direct Ownership Interest Jan 1, 2015 100%
Emily Eitzen Individual Corporate OfficerCeo Jun 27, 2025 100%
W-2 Managing EmployeeCeo Jun 27, 2025

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Fairview Regional Medical CenterFairview, OK, CCN 37Z329 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 17, 2014

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 1

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

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

Affiliated clinicians 58

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

View all 58

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477008000000",
    "number": "1033153309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 548",
            "city": "FAIRVIEW",
            "state": "OK",
            "postal_code": "737370548",
            "telephone_number": "580-227-3721",
            "fax_number": "580-227-2882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 E STATE RD",
            "city": "FAIRVIEW",
            "state": "OK",
            "postal_code": "737371453",
            "telephone_number": "580-227-3721",
            "fax_number": "580-227-2882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW REGIONAL MEDICAL CENTER AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2016-10-21",
        "status": "A",
        "authorized_official_last_name": "KNAK",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "580-227-3721"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "OK",
            "license": "2248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100700800A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairview Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairview, OK

Sources for this page

Verify at the official NPI Registry.