NPIMap

Organization Active NPI

Muskogee Regional Medical Center LLC

  • General Acute Care Hospital
  • Muskogee, OK
National Provider Identifier
1104968916
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
2177 Issued in OK
Legal business name
MUSKOGEE REGIONAL MEDICAL CENTER LLC
Practice address
300 Rockefeller Dr
Muskogee, OK 74401-5075
Phone
(918) 682-5501
Fax
(918) 684-2552
NPI assigned
Feb 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Authorized official

Name
Stephen L Page
Title
Ceo
Phone
(615) 844-9800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 2177 OK Primary

Addresses

Primary practice location

300 Rockefeller Dr
Muskogee, OK 74401-5075

Mailing address

103 Continental PL
Suite 200
Brentwood, TN 37027-1041
Phone (615) 844-9800

Other identifiers 2

IdentifierTypeStateIssuer
100700630AMedicaidOK
000370025001OtherOKBLUE CROSS PROVIDER ID

Other names 1

  • Eastar Health System Main Campus Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Muskogee Regional Medical Center LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489449600000",
    "number": "1104968916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 CONTINENTAL PL",
            "address_2": "SUITE 200",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370271041",
            "telephone_number": "615-844-9800",
            "fax_number": "615-844-9883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ROCKEFELLER DR",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744015075",
            "telephone_number": "918-682-5501",
            "fax_number": "918-684-2552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUSKOGEE REGIONAL MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2017-03-14",
        "status": "A",
        "authorized_official_last_name": "PAGE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "615-844-9800"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "OK",
            "license": "2177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100700630A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER ID",
            "identifier": "000370025001",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastar Health System Main Campus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Muskogee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; 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.