NPIMap

Organization Active NPI

Cordell Memorial Hospital 0189

Doing business as Cordell Hospital Authority dba Cordell Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Cordell, OK
National Provider Identifier
1205832003
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
2221 Issued in OK
Legal business name
CORDELL MEMORIAL HOSPITAL 0189
Doing business as
Cordell Hospital Authority dba Cordell Memorial Hospital
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
Last updated
Mar 3, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
CORDELL MEMORIAL HOSPITAL 0189As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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 1

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

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 names 1

  • Cordell Hospital Authority dba Cordell Memorial Hospital Doing business as

Medicare participation

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

Enrollment records 1

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1205832003. Details of each certification follow.

Hospital certification: CCN 37Z325

Legal name
CORDELL MEMORIAL HOSPITAL 0189
Doing business as
CORDELL MEMORIAL HOSPITAL
Organization structure
OtherNon-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

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

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
Part of
Cordell Memorial Hospit

Locations

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

Ownership & related parties

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 DirectorBoard 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 EmployeeBusiness Office Manager Apr 1, 2020
Kevin M Obrien Individual Operational/Managerial ControlCfo Apr 1, 2020
Melinda Laird Individual Operational/Managerial ControlCeo Apr 19, 2021
Janice Williams Individual Corporate DirectorBoard 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 ControlCfo May 20, 2021

Owners & managing parties with NPI records 8

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

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 HospitalCordell, OK, CCN 371325 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 3

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

Facilities with the same owner 10

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

Practitioners & affiliated clinicians

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1205832003",
    "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": "1220 N GLENN L ENGLISH ST",
            "city": "CORDELL",
            "state": "OK",
            "postal_code": "736322010",
            "telephone_number": "580-832-3339",
            "fax_number": "580-832-5076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORDELL MEMORIAL HOSPITAL 0189",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CORDELL MEMORIAL HOSPITAL 0189",
        "enumeration_date": "2005-06-27",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "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": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "OK",
            "license": "2221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cordell Hospital Authority dba Cordell Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cordell Hospital Authority dba Cordell Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cordell, OK

Sources for this page

Verify at the official NPI Registry.