Hospice of North Central Oklahoma, Inc

Key facts

NPI

1043201890

Entity type

Organization (NPI type 2)

Primary specialty

Community Based Hospice Care Agency 251G00000X

License

4003 (OK)

Legal business name

HOSPICE OF NORTH CENTRAL OKLAHOMA, INC

Practice address

445 Fairview Ave
Ponca City, OK 74601-1931

Phone

(580) 762-9102

Fax

(580) 765-3653

NPI assigned

Nov 1, 2005

Organization subpart

No

Authorized official

Name

Wendy Stobbe

Title

Chief Executive Officer

Phone

(580) 762-9102

Owners & managing parties with NPI records 1

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

• Melinda Rother Allen, DO Internal Medicine Physician · Ponca City, OK · NPI 1396737888
  CMS ownership CONTRACTED MANAGING EMPLOYEE

Practitioners 4

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

• Barbara Wright, LMSW, LCSW, ACHP-SW Clinical Social Worker · Ponca City, OK · NPI 1790336097
  NPD
• Karen S Adams, MD Family Medicine Physician · Ponca City, OK · NPI 1104818368
  NPD (past) FAMILY MEDICINE
• Melinda Rother Allen, DO Internal Medicine Physician · Ponca City, OK · NPI 1396737888
  NPD (past)
• Jeanine Dianne Deterding, ARNP General Practice Registered Nurse · Ponca City, OK · NPI 1033117072
  NPD (past)

Affiliated clinicians 3

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

• Melinda Rother Allen, DO Internal Medicine Physician · Ponca City, OK · NPI 1396737888
  Care Compare affiliation Hospice
• Christen Denise Ground, D.O. Family Medicine Physician · Ponca City, OK · NPI 1689021842
  Care Compare affiliation Hospice
• Aaron Paul Wilcox, D.O. Family Medicine Physician · Ponca City, OK · NPI 1518195221
  Care Compare affiliation Hospice

Medicare Care Compare: Hospice

Listed as

Hospice of North Central Oklahoma, Inc. CCN 371517

Ownership

Non-Profit

Certified

Apr 12, 1993

Medicare certification status

Active (Provider of Services file)

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

Medicare participation

Medicare fee-for-service enrollment

Enrolled in OK

Hospice certification: CCN 371517

Legal name

HOSPICE OF NORTH CENTRAL OKLAHOMA INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Apr 12, 1993

Last certification

Oct 20, 2017

Ownership / control type

Non-Profit - Private

Organization structure

Corporation · Non-profit

Incorporated

Apr 1, 1982 in OK

Enrollment address

445 Fairview Ave
Ponca City, OK 74601-1923

All disclosed owners & managing parties 5

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

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

Other names

• Hospice of Ponca City, Inc. Former legal business name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 7, 2020.

{
    "created_epoch": "1130803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588809600000",
    "number": "1043201890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 FAIRVIEW AVE",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746011931",
            "telephone_number": "580-762-9102",
            "fax_number": "580-765-3653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 FAIRVIEW AVE",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746011931",
            "telephone_number": "580-762-9102",
            "fax_number": "580-765-3653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICE OF NORTH CENTRAL OKLAHOMA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-01",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A",
        "authorized_official_last_name": "STOBBE",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "580-762-9102"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "OK",
            "license": "4003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hospice of Ponca City, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Hospice of Ponca City, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Ponca City, OK

• Holmes Medical Services PLC
• Kimberly Kay Holt, APRN
• Sharon Honick, RPT
• Betty Dolores Horinek, R.N.
• Janice Lynne Hosack
• Makayla Dawn Howard
• Paula Elaine Howard
• William Robert Howard, M.D.
• Vivian Deloyce Howe
• Janis Hudson

All providers in Ponca City, OK · Community Based Hospice Care Agency in Oklahoma