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Cordell Memorial Hospital 0189

Organization Active NPI Medicare Defined Swing Bed Hospital Unit · Cordell, OK

NPI 1205832003 · NPPES record last updated Mar 3, 2025

Key facts

NPI
1205832003
Entity type
Organization (NPI type 2)
Primary specialty
Medicare Defined Swing Bed Hospital Unit 275N00000X
License
2221 (OK)
Legal business name
CORDELL MEMORIAL HOSPITAL 0189
Practice address
1220 N Glenn L English St
Cordell, OK 73632-2010
Phone
(580) 832-3339
Fax
(580) 832-5076
NPI assigned
Jun 27, 2005
Organization subpart
Yes
Parent organization (as reported)
CORDELL MEMORIAL HOSPITAL 0189

Authorized official

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

Owners & managing parties with NPI records 8

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

Owned or controlled facilities with NPI records 3

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

Other NPIs with the same Medicare PAC ID 3

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

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

Facilities with the same owner 10

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

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OK

Hospital certification: CCN 37Z325

Legal name
CORDELL MEMORIAL HOSPITAL 0189
Doing business as
CORDELL MEMORIAL HOSPITAL
Organization structure
Other · Non-profit
Incorporated
Dec 12, 1988 in OK
Enrollment address
1220 N Glenn L English St
Cordell Memorial Hospital
Cordell, OK 73632-2010
Other Hospital Practice Location

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Mark R Wesner
Individual 		Corporate Director
Board Member		 Sep 28, 2016
Cordell Memorial Hospital 0189
Organization · Cordell, OK 		5% Or Greater Direct Ownership Interest Dec 1, 2003
Keith Gerlach
Individual 		Corporate Director Dec 3, 2019
Cheryl Putman
Individual 		W-2 Managing Employee
Business Office Manager		 Apr 1, 2020
Kevin M Obrien
Individual 		Operational/Managerial Control
Cfo		 Apr 1, 2020
Melinda Laird
Individual 		Operational/Managerial Control
Ceo		 Apr 19, 2021
Janice Williams
Individual 		Corporate Director
Board Member		 Oct 13, 1993
SSM Health Care of Oklahoma, Inc.
Organization · Oklahoma City,, OK
Non-profit 		Operational/Managerial Control Apr 1, 2020 100%
Georganna Buss
Individual 		Operational/Managerial Control
Cfo		 May 20, 2021

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Cordell Memorial Hospital
Cordell, OK · CCN 371325		 Hospital 5% Or Greater Direct Ownership Interest Dec 1, 2003
Cordell Memorial Hospital 0189
Cordell, OK · CCN 378505		 Rural health clinic Operational/Managerial Control (100%) Dec 12, 1988

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20080502000078 OK Part a Provider - Critical Access Hospital 1254239197 Practice locations: Cordell, OK

National Provider Directory

Part of
James N Hall III DO

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 2221 OK Yes

Addresses

Primary practice location

1220 N Glenn L English St
Cordell, OK 73632-2010

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
000370186001OtherOKBCBS OF OKLAHOMA
100819200BMedicaidOK
100819200AMedicaidOK

Other names

  • Cordell Hospital Authority dba Cordell Memorial Hospital Doing business as

Other providers in Cordell, OK

All providers in Cordell, OK · Medicare Defined Swing Bed Hospital Unit in Oklahoma

Sources for this page

Verify at the official NPI Registry.