NPIMap

Organization Active NPI

Sequoyah County City Trust

  • Registered Nurse
  • Sallisaw, OK
National Provider Identifier
1124143540
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4028 Issued in OK
Legal business name
SEQUOYAH COUNTY CITY TRUST
Practice address
213 E Redwood Ave
Sallisaw, OK 74955-2811
Phone
(918) 774-1100
Fax
(918) 774-1103
NPI assigned
Mar 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Charles E. Wade
Title
Ceo
Phone
(918) 774-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 4028 OK Primary

Addresses

Primary practice location

213 E Redwood Ave
Sallisaw, OK 74955-2811

Mailing address

PO Box 505
Sallisaw, OK 74955-0505
Phone (918) 774-1100

Other names 1

  • SMH Extended Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sequoyah County City Trust14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124143540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749550505",
            "telephone_number": "918-774-1100",
            "fax_number": "918-774-1103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 E REDWOOD AVE",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749552811",
            "telephone_number": "918-774-1100",
            "fax_number": "918-774-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEQUOYAH COUNTY CITY TRUST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "918-774-1100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "4028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMH Extended Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sallisaw, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.