NPIMap

Organization Active NPI

Grady Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Chickasha, OK
National Provider Identifier
1083720734
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
GRADY MEMORIAL HOSPITAL
Practice address
2220 W Iowa Ave
Chickasha, OK 73018-2738
Phone
(405) 224-2300
Fax
(405) 779-2413
NPI assigned
Aug 22, 2006
Last updated
Jan 6, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Authorized official

Name
Steve Pautler
Title
Ceo
Phone
(405) 779-2150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X NU Primary

Addresses

Primary practice location

2220 W Iowa Ave
Chickasha, OK 73018-2738

Mailing address

2220 W Iowa Ave
Chickasha, OK 73018-2738
Phone (405) 224-2300

Other identifiers 1

IdentifierTypeStateIssuer
100700820AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090723000808 OK Part A Provider - Hospital 0648175778 Practice locations: Chickasha, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083720734. Details of each certification follow.

Hospital certification: CCN 37U054

Legal name
GRADY MEMORIAL HOSPITAL
Organization structure
OtherNon-profit
Enrollment address
2220 W Iowa Ave
Chickasha, OK 73018-2738
Hospital Swing-Bed Unit
Hospital subgroups
Swing-bed approved

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

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Grady Mem Hospital DME6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

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
Jackie L McAdoo Individual W-2 Managing EmployeeCfo Jan 1, 2016
John Pautler Individual Corporate OfficerCeo May 1, 2025

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Five Oaks Family Medical ClinicChickasha, OK, CCN 373478 Rural health clinic Operational/Managerial Control (100%) Jan 1, 2014
Tuttle Family Medical ClinicTuttle, OK, CCN 378546 Rural health clinic Operational/Managerial Control Sep 1, 2021

Owned or controlled facilities with NPI records 2

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

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": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767657600000",
    "number": "1083720734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 W IOWA AVE",
            "city": "CHICKASHA",
            "state": "OK",
            "postal_code": "730182738",
            "telephone_number": "405-224-2300",
            "fax_number": "405-779-2413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 W IOWA AVE",
            "city": "CHICKASHA",
            "state": "OK",
            "postal_code": "730182738",
            "telephone_number": "405-224-2300",
            "fax_number": "405-779-2413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRADY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A",
        "authorized_official_last_name": "PAUTLER",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "405-779-2150"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100700820A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chickasha, OK

Sources for this page

Verify at the official NPI Registry.