NPIMap

Organization Active NPI

Oklahoma Heart Hospital, LLC

  • General Acute Care Hospital
  • Oklahoma City, OK
National Provider Identifier
1083617005
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
OKLAHOMA HEART HOSPITAL, LLC
Practice address
4050 W Memorial Rd
Oklahoma City, OK 73120-8382
Phone
(405) 608-3200
NPI assigned
May 23, 2005
Last updated
Jun 29, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Authorized official

Name
Tracy Enloe
Title
Cfo
Phone
(405) 608-3302

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X
General Acute Care Hospital 282N00000X Primary
Special Hospital 284300000X 2354 OK

Addresses

Primary practice location

4050 W Memorial Rd
Oklahoma City, OK 73120-8382

Mailing address

4050 W Memorial Rd
Oklahoma City, OK 73120-8382
Phone (405) 608-3200

Other practice location 1

5200 E I 240 Service Rd
Oklahoma City, OK 73135-2607
Phone (405) 608-3200

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040319001119 OK Part A Provider - Hospital 7113817248 Practice locations: Yukon, OK; Oklahoma City, OK; Midwest City, OK; Edmond, OK; Bethany, OK
O20150127000456 OK Part B Supplier - Intensive Cardiac Rehabilitation 7113817248 Receives reassigned benefits from 1 practitioner
Practice locations: Oklahoma City, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083617005. Details of each certification follow.

Hospital certification: CCN 370215

Legal name
OKLAHOMA HEART HOSPITAL, LLC
Doing business as
OKLAHOMA HEART HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Oct 25, 2002
Last certification
Oct 22, 2025
Beds
97
Ownership / control type
Physician ownership
Organization structure
LLCProprietary
Enrollment address
4050 W Memorial Rd
Oklahoma City, OK 73120-8382
Main/Primary Hospital Location
Hospital subgroups
Acute care, Specialty hospital

Care Compare: Hospital

Medicare Care Compare
Listed as
Oklahoma Heart Hospital, LLCCCN 370215 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Physician
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member of 1

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

Member organizations 4

Organizations listed as members of this organization in the National Provider Directory.

Locations

11995 Singletree Ln
Ste 500
Eden Prairie, MN 55344
Phone (952) 595-1143

1301 N Council Ave
Blanchard, OK 73010

8121 National Ave
Ste 202
Midwest City, OK 73110
Phone (405) 242-5880

8121 National Ave
Ste 209
Midwest City, OK 73110
Phone (405) 608-6827

3048 SW 89th St
Ste B
Oklahoma City, OK 73159
Phone (405) 464-8819

4700 Gaillardia Pkwy
Ste 200
Oklahoma City, OK 73142

5224 E I 240 Service Rd
Ste 204
Oklahoma City, OK 73135

5224 E I 240 Service Rd
Ste 206
Oklahoma City, OK 73135

5224 E I 240 Service Rd
Ste 301
Oklahoma City, OK 73135
Phone (405) 628-6800

5520 N Francis Ave
Oklahoma City, OK 73118
Phone (405) 840-0088

7800 NW 85th Ter
Oklahoma City, OK 73132
Phone (405) 972-7239

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
Jesse R Campbell Individual Corporate Director Apr 17, 2021 7.7%
Peggy D Tipton Individual Corporate OfficerCoo Feb 17, 2003
W-2 Managing EmployeeCoo Apr 1, 2004
Kevin W Miller Individual Corporate Director Apr 24, 2023
Paul Jenson Individual Corporate DirectorBoard Member Apr 17, 2021 7.7%
Thomas Anthony Hennebry Individual Corporate DirectorBoard Member Apr 28, 2025
Stephanie L Armstrong Individual Corporate OfficerCompliance Officer Jun 1, 2010
W-2 Managing EmployeeCompliance Officer Jun 1, 2010
Michael E Schoeffler Individual Corporate DirectorBoard Member Apr 28, 2025
David Miles Individual Corporate OfficerCio Nov 2, 2020
W-2 Managing EmployeeCio Nov 2, 2020
Jeffrey Peter Ciaramita Individual Corporate DirectorBoard Member Apr 28, 2025
Denise R Bragg Individual Corporate OfficerCno Jun 6, 2016
W-2 Managing EmployeeCno Jun 6, 2016
Mazen Abu-Fadel Individual Corporate Director Apr 24, 2023
Andrew D Wirth Individual W-2 Managing EmployeeCompliance & Privacy Director Nov 1, 2016
John R Harvey Individual Corporate OfficerCeo & Board Member Feb 1, 2007
Corporate DirectorCeo & Board Member Apr 17, 2021 7.7%
W-2 Managing EmployeeCeo & Board Member Jan 28, 2007
Mercy Health Oklahoma Communities Organization, Oklahoma City, OK Corporation, Non-profit 5% Or Greater Direct Ownership Interest Aug 8, 2016 45.19%
Zackary L Dawson Individual Corporate Director May 8, 2023
Michael L Watson Individual Corporate DirectorBoard Member Jul 28, 2025
Tracy Enloe Individual Corporate OfficerChief Financial Officer Apr 1, 2020
W-2 Managing EmployeeChief Financial Officer Apr 1, 2020
Naeem K Tahirkheli Individual Corporate DirectorBoard Member Mar 15, 2024
Christopher F Hahne Individual Corporate DirectorBoard Member Mar 1, 2024
Soni J Zacharias Individual Corporate DirectorBoard Member Mar 15, 2024
Patrick Holloway Individual Corporate OfficerCoo Clinic Operations Jul 1, 2010
W-2 Managing EmployeeCoo Clinic Operations Jul 1, 2010
Brian Bennett Geister Individual Corporate DirectorBoard Member Sep 10, 2024

Owners & managing parties with NPI records 9

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
Oklahoma Heart Hospital SouthOklahoma City, OK, CCN 370234 Hospital 5% Or Greater Direct Ownership Interest (76%) Jan 11, 2010

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 26

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

View all 26

Practitioners & affiliated clinicians

Practitioners 93

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 93

Affiliated clinicians 360

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

View all 360

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687996800000",
    "number": "1083617005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 W MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208382",
            "telephone_number": "405-608-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 W MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208382",
            "telephone_number": "405-608-3200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5200 E I 240 Service Rd",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731352607",
            "country_code": "US",
            "telephone_number": "405-608-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OKLAHOMA HEART HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A",
        "authorized_official_last_name": "ENLOE",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "405-608-3302"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": "OK",
            "license": "2354",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.