NPIMap

Organization Active NPI

Newman Memorial Hospital, Inc

  • Critical Access Hospital
  • Shattuck, OK
National Provider Identifier
1083617807
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
2243 Issued in OK
Legal business name
NEWMAN MEMORIAL HOSPITAL, INC
Practice address
905 S Main St
Shattuck, OK 73858
Phone
(580) 938-2551
Fax
(580) 938-2615
NPI assigned
May 24, 2005
Last updated
May 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Authorized official

Name
Mr. Eddie Jackson Majors, CEO
Title
Chief Executive Officer
Phone
(580) 938-2551

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 2243 OK Primary

Addresses

Primary practice location

905 S Main St
Shattuck, OK 73858

Mailing address

905 S Main St
Shattuck, OK 73858-9205
Phone (580) 938-2551

Other identifiers 6

IdentifierTypeStateIssuer
000370007001OtherOKBLUE CROSS
100699360AMedicaidOK
073846001MedicaidTX
127341905MedicaidTX
100699360BMedicaidOK
127341901MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20051122000749 OK Part B Supplier - Clinic/Group Practice 2567482367 Receives reassigned benefits from 61 practitioners
3 other NPIs on this enrollment
Practice locations: Woodward, OK; Mooreland, OK; Shattuck, OK
O20160811000217 OK Part A Provider - Critical Access Hospital 2567482367 Receives reassigned benefits from 20 practitioners
Practice locations: Shattuck, OK
O20160811000419 OK Part A Provider - Critical Access Hospital 2567482367 Receives reassigned benefits from 36 practitioners
Practice locations: Shattuck, OK

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1083617807. Details of each certification follow.

Hospital certification: CCN 37Z336

Legal name
NEWMAN MEMORIAL HOSPITAL, INC
Organization structure
CorporationNon-profit
Incorporated
Sep 10, 2002 in OK
Enrollment address
905 S Main St
Shattuck, OK 73858-9205
Other Hospital Practice Location

Hospital certification: CCN 371336

Legal name
NEWMAN MEMORIAL HOSPITAL, INC
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Apr 28, 2016
Last certification
May 30, 2025
Beds
79
Ownership / control type
Hospital district or authority
Organization structure
CorporationNon-profit
Incorporated
Sep 10, 2002 in OK
Enrollment address
905 South Main St
Shattuck, OK 73858-9205

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

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Newman Memorial HospitalCCN 371336 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Rhonda Hayes Individual W-2 Managing Employee May 23, 2018
Angela Prather Individual Corporate DirectorBoard Member May 1, 2006
Gregory S Huenergardt Individual Corporate OfficerPresident of the Board of Direct May 23, 2018
Corporate OfficerPresident of the Board of Directo Apr 1, 2008
Danna K Stuart Individual Corporate DirectorChief of Staff, Director Aug 1, 2006
Corporate DirectorChief of Staff,Director Aug 1, 2006
Stacy D Holland Individual Corporate OfficerChief Executive Officer Mar 7, 2021
John Cully Individual Corporate Director Sep 30, 2016
Jenilee Hinkle Individual Corporate DirectorBoard Member Aug 1, 2016
Corporate Director Sep 30, 2016
Thomas R Vasko Individual W-2 Managing EmployeeCeo Feb 9, 2023
Brittany C Rash Individual W-2 Managing EmployeeAccountant Mar 1, 2024
Ricky Messer Individual Corporate Director Mar 1, 2020

Owners & managing parties with NPI records 1

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
Newman Healthcare Associates WoodwardWoodward, OK, CCN 378563 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 64

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 64

Affiliated clinicians 40

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

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589414400000",
    "number": "1083617807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 S MAIN ST",
            "city": "SHATTUCK",
            "state": "OK",
            "postal_code": "738589205",
            "telephone_number": "580-938-2551",
            "fax_number": "580-938-2615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 S MAIN ST",
            "city": "SHATTUCK",
            "state": "OK",
            "postal_code": "73858",
            "telephone_number": "580-938-2551",
            "fax_number": "580-938-2615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWMAN MEMORIAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A",
        "authorized_official_last_name": "MAJORS",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_middle_name": "JACKSON",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "580-938-2551",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "OK",
            "license": "2243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000370007001",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100699360A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "073846001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127341905",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100699360B",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127341901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shattuck, OK

Sources for this page

Verify at the official NPI Registry.