NPIMap

Organization Active NPI

Southern Plains Medical Center of Garvin County LLC

Doing business as Valley Community Hospital

  • Rural Acute Care Hospital
  • Pauls Valley, OK
National Provider Identifier
1053997338
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
Legal business name
SOUTHERN PLAINS MEDICAL CENTER OF GARVIN COUNTY LLC
Doing business as
Valley Community Hospital
Practice address
100 Valley Dr
Pauls Valley, OK 73075-6613
Phone
(405) 866-5100
NPI assigned
Mar 18, 2021
Last updated
Mar 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Authorized official

Name
Madhukar Sharma
Title
Owner
Phone
(904) 238-3752

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered Nurse 163WW0000X
Internal Medicine Physician 207R00000X
General Practice Physician 208D00000X
Medicare Defined Swing Bed Hospital Unit 275N00000X
General Acute Care Hospital 282N00000X
Rural Acute Care Hospital 282NR1301X Primary

Addresses

Primary practice location

100 Valley Dr
Pauls Valley, OK 73075-6613

Mailing address

100 Valley Dr
Pauls Valley, OK 73075-6613
Phone (405) 866-5100

Other names 2

  • VALLEY COMMUNITY HOSPITAL Doing business as
  • Valley Community Clinic Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210610002722 OK Part A Provider - Hospital 5496155582 Practice locations: Pauls Valley, OK
O20210617000272 OK Part B Supplier - Clinic/Group Practice 5496155582 Receives reassigned benefits from 33 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Edmond, OK; Pauls Valley, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053997338. Details of each certification follow.

Hospital certification: CCN 370243

Legal name
SOUTHERN PLAINS MEDICAL CENTER OF GARVIN COUNTY LLC
Doing business as
VALLEY COMMUNITY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Aug 10, 2021
Last certification
Aug 10, 2021
Beds
43
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Jul 9, 2020 in OK
Enrollment address
100 Valley Dr
Pauls Valley, OK 73075-6613
Main/Primary Hospital Location
Hospital subgroups
General, Acute care, Short-term, Swing-bed approved, Psychiatric unit, Rehabilitation unit, Specialty hospital, Other

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Valley Community HospitalCCN 370243 · All quality measures
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

1218 E 9th St
Ste 1
Edmond, OK 73034
Phone (405) 856-0020

100 Valley Dr
Ste 1A
Pauls Valley, OK 73075
Phone (405) 866-5100

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Madhukar Sharma Individual 5% Or Greater Direct Ownership InterestOwner Apr 28, 2022 75%
Operational/Managerial Control Apr 28, 2022
Giancarlo Gasparini Individual 5% Or Greater Direct Ownership Interest Apr 28, 2022 25%

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 33

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 33

NPI Registry JSON

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

{
    "created_epoch": "1616025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709856000000",
    "number": "1053997338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 VALLEY DR",
            "city": "PAULS VALLEY",
            "state": "OK",
            "postal_code": "730756613",
            "telephone_number": "405-866-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 VALLEY DR",
            "city": "PAULS VALLEY",
            "state": "OK",
            "postal_code": "730756613",
            "telephone_number": "405-866-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN PLAINS MEDICAL CENTER OF GARVIN COUNTY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-18",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "MADHUKAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-238-3752"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VALLEY COMMUNITY HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Valley Community Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pauls Valley, OK

Sources for this page

Verify at the official NPI Registry.