NPIMap

Organization Active NPI

SSM Health Care of Oklahoma, Inc.

Doing business as SSM Health St. Anthony Hospital - Oklahoma City

  • Psychiatric Hospital Unit
  • Oklahoma City, OK
National Provider Identifier
1114025012
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
2304 Issued in OK
Legal business name
SSM HEALTH CARE OF OKLAHOMA, INC.
Doing business as
SSM Health St. Anthony Hospital - Oklahoma City
Practice address
1000 N Lee Ave
Oklahoma City, OK 73102
Phone
(405) 272-7000
NPI assigned
Sep 21, 2006
Last updated
Nov 27, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
SSM HEALTH CARE OF OKLAHOMA, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Shasta Rene Manuel
Title
Regional VP - Finance
Phone
(405) 272-7279

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 2304 OK Primary

Addresses

Primary practice location

1000 N Lee Ave
Oklahoma City, OK 73102

Mailing address

1000 N Lee Ave
Oklahoma City, OK 73102-1036
Phone (405) 272-7000

Other names 1

  • SSM Health St. Anthony Hospital - Oklahoma City Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080616000514 OK Part A Provider - Hospital 6709771207 Practice locations: Oklahoma City, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114025012. Details of each certification follow.

Hospital certification: CCN 37S037

Legal name
SSM HEALTH CARE OF OKLAHOMA, INC.
Doing business as
SSM HEALTH ST ANTHONY HOSPITAL - OKLAHOMA CITY
Organization structure
CorporationNon-profit
Incorporated
Nov 24, 1952 in OK
Enrollment address
1000 N Lee Ave
Oklahoma City, OK 73102-1036
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

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

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Sah Op CLN56 organizations share this tax ID, including this one
Part of
Sah Op CLN

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Kersey L Winfree Individual Corporate Director Jan 1, 2016
Shasta R Manuel Individual Operational/Managerial Control Jan 1, 2016
Joe M Hodges Individual Corporate Director Nov 27, 2007
W-2 Managing Employee Nov 27, 2007
Michael P Collison Individual Corporate Director Jan 1, 2016
Romona a Carey Individual Corporate Director Nov 27, 2007
Paula Friedman Individual Corporate Director Jan 1, 2016
William P Thompson Individual Corporate Director Jan 1, 2016
Marion McMillan Individual Corporate Director Jan 1, 2016
Tamara Lynn Powell Individual Corporate Director Jan 1, 2016
Martha Ann Burger Individual Corporate Director Jan 1, 2016
SSM Health Care of Oklahoma, Inc. Organization, Oklahoma City, OK 5% Or Greater Direct Ownership Interest Nov 27, 2007
Operational/Managerial Control Nov 27, 2007
Charles E Skillings Individual Corporate Director Jan 1, 2016
David R Harlow Individual Corporate Director Jan 1, 2016
Major Berry Individual Corporate Director Jan 1, 2016
Robert W Rader Individual Corporate Director Jan 1, 2016
Jenee Lister Individual Corporate Director Jan 1, 2016
Mary Jean Ryan Individual Corporate Director Nov 27, 2007
Margaret C Salyer Individual Corporate Director Nov 27, 2007
June L Pickett Individual Corporate Director Nov 27, 2007

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 9

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

FacilityTypeRoleSince
Cordell Memorial HospitalCordell, OK, CCN 371325 Hospital Operational/Managerial Control (100%) Apr 1, 2020
Cordell Memorial HospitalCordell, OK, CCN 37Z325 Hospital Operational/Managerial Control (100%) Apr 1, 2020
Purcell Municipal HospitalPurcell, OK, CCN 370158 Hospital Operational/Managerial Control Jul 1, 2021
SSM Health St Anthony Hospital - Oklahoma CityOklahoma City, OK, CCN 370037 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Nov 27, 2007
Nov 27, 2007
St. Anthony Shawnee HospitalShawnee, OK, CCN 370149 Hospital Operational/Managerial Control (100%) Jul 1, 2012
SSM Health St. Anthony Hospital - Oklahoma CityBuffalo, OK, CCN 370781 Hospital Operational/Managerial Control (100%) Oct 1, 2019
SSM Health Rehabilitation Hospital - Oklahoma CityOklahoma City, OK, CCN 373025 Hospital 5% Or Greater Direct Ownership Interest (49%) Dec 10, 2024
Buffalo Family Health ClinicBuffalo, OK, CCN 378539 Rural health clinic Operational/Managerial Control (100%) Oct 1, 2019
Laverne Family Health ClinicLaverne, OK, CCN 378540 Rural health clinic Operational/Managerial Control (100%) Oct 1, 2019

Owned or controlled facilities with NPI records 12

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

Facilities with the same owner 9

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

Practitioners & affiliated clinicians

Practitioners 5

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": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1114025012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N LEE AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731021036",
            "telephone_number": "405-272-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N LEE AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73102",
            "telephone_number": "405-272-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSM HEALTH CARE OF OKLAHOMA, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSM HEALTH CARE OF OKLAHOMA, INC.",
        "enumeration_date": "2006-09-21",
        "last_updated": "2023-11-27",
        "certification_date": "2020-02-04",
        "status": "A",
        "authorized_official_last_name": "MANUEL",
        "authorized_official_first_name": "SHASTA",
        "authorized_official_middle_name": "RENE",
        "authorized_official_title_or_position": "REGIONAL VP - FINANCE",
        "authorized_official_telephone_number": "405-272-7279"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "OK",
            "license": "2304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "SSM Health St. Anthony Hospital - Oklahoma City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.