NPIMap

Organization Active NPI

Green Country Medical, Inc

Doing business as Green Country Rural Health Center

  • Family Medicine Physician
  • South Coffeyville, OK
National Provider Identifier
1083837439
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GREEN COUNTRY MEDICAL, INC
Doing business as
Green Country Rural Health Center
Practice address
228 Willow
South Coffeyville, OK 74072
Phone
(918) 255-6000
NPI assigned
Apr 11, 2007
Last updated
Jul 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Authorized official

Name
Lacee Hayes
Title
RN
Phone
(918) 273-0140

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

228 Willow
South Coffeyville, OK 74072

Mailing address

712 E Osage Ave
Nowata, OK 74048-3638

Other identifiers 1

IdentifierTypeStateIssuer
100739790FMedicaidOK

Other names 1

  • Green Country Rural Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Green Country Medical Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1083837439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 E OSAGE AVE",
            "city": "NOWATA",
            "state": "OK",
            "postal_code": "740483638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 WILLOW",
            "city": "SOUTH COFFEYVILLE",
            "state": "OK",
            "postal_code": "74072",
            "telephone_number": "918-255-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN COUNTRY MEDICAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "LACEE",
        "authorized_official_title_or_position": "RN",
        "authorized_official_telephone_number": "918-273-0140"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100739790F",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Green Country Rural Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Coffeyville, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.