Sequoyah County-City of Sallisaw Hospital Authority

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

2189 Issued in OK

Legal business name

SEQUOYAH COUNTY-CITY OF SALLISAW HOSPITAL AUTHORITY

Doing business as

SMH Primary Health Care

Practice address

409 E Redwood Ave
Sallisaw, OK 74955-3018

Phone

(918) 790-3309

Fax

(918) 775-0587

NPI assigned

Jul 17, 2012

Last updated

Aug 8, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

SEQUOYAH COUNTY CITY OF SALLISAW HOSPITAL AUTHORITYAs reported in NPPES

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

Authorized official

Name

Mrs. Debra R Knoke, CEO

Title

Administrator

Phone

(918) 774-1100

Specialties & licenses 1

Addresses

Other names 1

• SMH Primary Health Care Doing business as

Part of

Sequoyah Memorial Hospital

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344384000000",
    "number": "1205181112",
    "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": "918-790-3309",
            "fax_number": "918-775-0587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 E REDWOOD AVE",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749553018",
            "telephone_number": "918-790-3309",
            "fax_number": "918-775-0587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEQUOYAH COUNTY-CITY OF SALLISAW HOSPITAL AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SEQUOYAH COUNTY CITY OF SALLISAW HOSPITAL AUTHORITY",
        "enumeration_date": "2012-07-17",
        "last_updated": "2012-08-08",
        "status": "A",
        "authorized_official_last_name": "KNOKE",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "918-774-1100",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OK",
            "license": "2189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMH Primary Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sequoyah County City Trust (SMH Clinic)
• Sequoyah County City Trust Authority (Sequoyah Memorial Hospital)
• Sequoyah County Drug Company PLLC
• Sequoyah County-City of Sallisaw Hospital Authority (SMH Redwood Clinic)
• Sequoyah County-City of Sallisaw Hospital Authority (Northeastern Health System Sequoyah)
• Sequoyah Manor LLC
• Sequoyah Memorial Hospital
• Sequoyah Residential Mental Health Facility, Inc
• Jaime Severns
• Amanda Renee Shackelford

• Clinic/Center in Sallisaw, OK
• Providers in Sallisaw, OK by specialty
• Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; 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.