Leflore County Hospital Authority
Organization Active NPI Psychiatric Hospital Unit · Poteau, OK
NPI 1184997447 · NPPES record last updated May 20, 2016
Key facts
- NPI
- 1184997447
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric Hospital Unit 273R00000X
- Legal business name
- LEFLORE COUNTY HOSPITAL AUTHORITY
- Practice address
- 105 Wall St
Poteau, OK 74953-4433 - Phone
- (918) 647-8161
- NPI assigned
- Feb 17, 2012
- Organization subpart
- No
Authorized official
- Name
- Mr. Michael J Carter
- Title
- Ceo/Administrator
- Phone
- (918) 635-3300
Owners & managing parties with NPI records 5
-
Tiffany B Griffis, NP-C
Other NPIs on the same Medicare enrollment 1
Related certifications (CCN) 4
Affiliated clinicians 99
-
John P Agent, DO
-
Shelly Dawn Anderson, DNP APRN, CNP
-
Alanna Briane Barfoot, D.O.
-
Tabetha Jarel Brown, APRN
-
Kensie Bush, APRN-CNP
-
Jonathan Scott Clark, D.O.
-
Julie Clark, P.A.
-
Delaina Larae Davis, APRN
-
Elizabeth Trudy Davis, APRN-CNP
-
Daneal Chandel Dobbs, ARNP
-
Julie Annette Fioretti, APRN - FNP
-
Janet L Garvin, D.O.
-
Jeanne R Guinn, APRN
-
Emily L Harrah, APRN-FNP
-
Autumn R Hembree, NP
-
Beth Hites, DO
-
Linda J Hoffman, APRN
-
Krystel Huddleston, DNP, APRN, FNP-C
-
Nathan Klammer, MD
-
Derek Knotts, M.D.
-
Cynthia Renee Leatherwood, APRN, FNP-BC
Medicare Care Compare: Hospital
- Listed as
- Eastern Oklahoma Medical Center
- Overall star rating
- ★★★★☆ 4 of 5
- Type
- Critical Access Hospitals
- Ownership
- Government - Local
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Hospital certification: CCN 371337
- Legal name
- LEFLORE COUNTY HOSPITAL AUTHORITY
- Doing business as
- EASTERN OKLAHOMA MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Oct 22, 2016
- Last certification
- Nov 2, 2023
- Beds
- 25
- Ownership / control type
- Local
- Organization structure
- Other · Non-profit
- Incorporated
- Jul 6, 1977 in OK
- Enrollment address
- 105 Wall St
Poteau, OK 74953-4433
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| Bradley Dedmon |
Operational/Managerial Control |
Jan 1, 2021 | |
| Carl Robert Reed |
Corporate Director |
May 1, 2014 | |
| Logan Hayes |
Corporate Officer |
May 23, 2023 | |
| Garry Ivey |
Other |
Jan 1, 2021 | |
| Darla Ford |
W-2 Managing Employee |
Jan 1, 2020 | |
| Leflore County Hospital Authority |
Operational/Managerial Control | Apr 1, 2015 | |
| Joe Mode |
Operational/Managerial Control |
Jul 1, 2021 | |
| Tiffany B Griffis |
Corporate Officer |
Aug 28, 2023 | |
| Audrey Balentine |
Operational/Managerial Control |
Jul 19, 2019 | |
| Jerry Andrews |
Corporate Director |
Jul 1, 2010 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150520000247 | OK | Part a Provider - Critical Access Hospital | 7719916956 |
Receives reassigned benefits from 1 practitioner 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Poteau, OK |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital Unit | 273R00000X | OK | Yes |
Addresses
Primary practice location
105 Wall St
Poteau, OK 74953-4433
Mailing address
PO Box 1148
Poteau, OK 74953-1148
Phone (918) 647-8161
Other names
- Mountain Gateway Senior Health
Other providers in Poteau, OK
- Daniel Laurence
- Cynthia Renee Leatherwood
- Vanessa Gail Lee
- Leflore County
- Leflore County Hospital Authority
- Leflore County Hospital Authority
- Leflore County Hospital Authority
- Leflore County Hospital Authority
- Leflore County Hospital Authority
- Leflore County Hospital Authority
All providers in Poteau, OK · Psychiatric Hospital Unit in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.