NPIMap

Organization Active NPI

Cordell Memorial Hospital 0189

Doing business as Cordell Memorial Hospital Clinic

  • Clinic/Center
  • Cordell, OK
National Provider Identifier
1134532344
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
2221 Issued in OK
Legal business name
CORDELL MEMORIAL HOSPITAL 0189
Doing business as
Cordell Memorial Hospital Clinic
Practice address
1109 N Glenn L English St
Cordell, OK 73632-2007
Phone
(580) 832-3339
Fax
(580) 832-5076
NPI assigned
Jun 5, 2014
Last updated
Mar 31, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Authorized official

Name
Georganna Lea Buss
Title
Cfo
Phone
(580) 774-4762

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X
Clinic/Center 261Q00000X 2221 OK Primary

Addresses

Primary practice location

1109 N Glenn L English St
Cordell, OK 73632-2007

Mailing address

1220 N Glenn L English St
Cordell, OK 73632-2010
Phone (580) 832-3339

Other names 1

  • Cordell Memorial Hospital Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150216000491 OK Part B Supplier - Clinic/Group Practice 1254239197 Receives reassigned benefits from 6 practitioners
Practice locations: Cordell, OK

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Cordell Memorial Hospit5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 3

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 5% Or Greater Direct Ownership Interest Dec 1, 2003
Cordell Memorial HospitalCordell, OK, CCN 37Z325 Hospital 5% Or Greater Direct Ownership Interest Dec 1, 2003
Cordell Memorial Hospital 0189Cordell, OK, CCN 378505 Rural health clinic Operational/Managerial Control (100%) Dec 12, 1988

Owned or controlled facilities with NPI records 4

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

Practitioners & affiliated clinicians

Practitioners 12

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": "1401926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774915200000",
    "number": "1134532344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 N GLENN L ENGLISH ST",
            "city": "CORDELL",
            "state": "OK",
            "postal_code": "736322010",
            "telephone_number": "580-832-3339",
            "fax_number": "580-832-5076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 N GLENN L ENGLISH ST",
            "city": "CORDELL",
            "state": "OK",
            "postal_code": "736322007",
            "telephone_number": "580-832-3339",
            "fax_number": "580-832-5076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORDELL MEMORIAL HOSPITAL 0189",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-05",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A",
        "authorized_official_last_name": "BUSS",
        "authorized_official_first_name": "GEORGANNA",
        "authorized_official_middle_name": "LEA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "580-774-4762"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OK",
            "license": "2221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cordell Memorial Hospital Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cordell Memorial Hospital Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cordell, OK

Sources for this page

Verify at the official NPI Registry.