Active NPI
Woodward Health System LLC
- Rural Health Clinic/Center
- Woodward, OK
National Provider Identifier
1063767259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rural Health Clinic/Center
- Legal business name
- WOODWARD HEALTH SYSTEM LLC
- Practice address
- 1611 Main St Ste 102
Woodward, OK 73801-3064 - Phone
- (580) 254-8692
- Fax
- (580) 254-2718
- NPI assigned
- Jul 13, 2012
- Organization subpart
- Yes
- Parent organization
- WOODWARD HEALTH SYSTEM LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Paula Lalor
- Title
- Director/Delegated Official
- Phone
- (629) 215-3953
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Primary |
Addresses
Primary practice location
1611 Main St Ste 102
Woodward, OK 73801-3064
Mailing address
900 17TH St
Woodward, OK 73801-2448
Phone (580) 256-5511
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20019120J | Medicaid | OK |
Other names 1
- AllianceHealth Woodward Clinics
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Part of
- Woodward Health System LLC
Locations
1611 Main St
Ste 102
Woodward, OK 73801
Phone (580) 254-8192
Ownership & related parties
Change-of-ownership history 1
| Date | Event | Counterparty |
|---|---|---|
| Nov 1, 2023 | Change of Ownership | Integris Health Medical Group |
Change of ownership 1
Medicare changes of ownership in which this facility was the buyer or the seller.
-
- Rural Health Clinic/Center
- Woodward, OK
- NPI 1033981675
Sold to, 2023-11-01
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342137600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1687392000000",
"number": "1063767259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 17TH ST",
"city": "WOODWARD",
"state": "OK",
"postal_code": "738012448",
"telephone_number": "580-256-5511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 MAIN ST STE 102",
"city": "WOODWARD",
"state": "OK",
"postal_code": "738013064",
"telephone_number": "580-254-8692",
"fax_number": "580-254-2718"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WOODWARD HEALTH SYSTEM LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WOODWARD HEALTH SYSTEM LLC",
"enumeration_date": "2012-07-13",
"last_updated": "2023-06-22",
"certification_date": "2023-06-22",
"status": "A",
"authorized_official_last_name": "LALOR",
"authorized_official_first_name": "PAULA",
"authorized_official_title_or_position": "DIRECTOR/DELEGATED OFFICIAL",
"authorized_official_telephone_number": "629-215-3953"
},
"taxonomies": [
{
"code": "261QR1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rural Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20019120J",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "AllianceHealth Woodward Clinics",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Woodward, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.