NPIMap

Organization Active NPI

Jane Phillips Nowata Health Center

  • Critical Access Hospital
  • Nowata, OK
National Provider Identifier
1053447086
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
2187 Issued in OK
Legal business name
JANE PHILLIPS NOWATA HEALTH CENTER
Practice address
237 S Locust St
Nowata, OK 74048-3660
Phone
(918) 331-5413
NPI assigned
Feb 26, 2007
Last updated
Apr 12, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
JANE PHILLIPS NOWATA HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Authorized official

Name
Jason R McCauley
Title
Administrator
Phone
(918) 273-3102

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 2187 OK Primary

Addresses

Primary practice location

237 S Locust St
Nowata, OK 74048-3660

Mailing address

237 S Locust St
Nowata, OK 74048-3660
Phone (918) 331-5413

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080527000723 OK Part A Provider - Critical Access Hospital 5092797761 Practice locations: Nowata, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053447086. Details of each certification follow.

Hospital certification: CCN 37Z305

Legal name
JANE PHILLIPS NOWATA HEALTH CENTER
Doing business as
ASCENSION JANE PHILLIPS NOWATA
Organization structure
CorporationNon-profit
Incorporated
Sep 8, 1998 in OK
Enrollment address
237 S Locust
Nowata, OK 74048-0426
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Jane Phillips Nowata Health2 organizations share this tax ID, including this one
Part of
Jane Phillips Nowata Health

Other organizations with this tax ID 1

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

Member of 1

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

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Jane Phillips Memorial Medical Center Inc Organization, Bartlesville, OK Created for acquisition, Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 1999 100%
Brad Rector Individual Corporate DirectorBoard Member Jan 1, 2024 5%
Bert Walthall Individual Corporate DirectorBoard Member Jan 1, 2024 5%
Paul Atkisson Individual Corporate DirectorBoard Member Jan 1, 2024 5%
Stephen Colaw Individual Corporate DirectorBoard Member Jan 1, 2024 5%
Paul McQuillen Individual Corporate DirectorBoard Member Jan 1, 2024 5%
Tammie Strobel Individual Corporate DirectorBoard Member Jan 1, 2024 5%
Jason McCuley Individual Corporate OfficerAdministrator Apr 18, 2016 5%
W-2 Managing EmployeeAdministrator Apr 18, 2016 5%
Anderson Mehrle Individual Corporate DirectorBoard Member Jan 1, 2024 5%

Owners & managing parties with NPI records 4

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

Facilities with the same owner 5

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618185600000",
    "number": "1053447086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 S LOCUST ST",
            "city": "NOWATA",
            "state": "OK",
            "postal_code": "740483660",
            "telephone_number": "918-331-5413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 S LOCUST ST",
            "city": "NOWATA",
            "state": "OK",
            "postal_code": "740483660",
            "telephone_number": "918-331-5413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JANE PHILLIPS NOWATA HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JANE PHILLIPS NOWATA HEALTH CENTER",
        "enumeration_date": "2007-02-26",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A",
        "authorized_official_last_name": "MCCAULEY",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "918-273-3102"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "OK",
            "license": "2187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nowata, OK

Sources for this page

Verify at the official NPI Registry.