NPIMap

Organization Active NPI

Carter Healthcare Hospice of East Oklahoma, LLC

Doing business as Carter Healthcare & Hospice

  • Community Based Hospice Care Agency
  • Tahlequah, OK
National Provider Identifier
1245347632
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
4153 Issued in OK
Legal business name
CARTER HEALTHCARE HOSPICE OF EAST OKLAHOMA, LLC
Doing business as
Carter Healthcare & Hospice
Practice address
200 Harris Cir Ste a
Tahlequah, OK 74464-8899
Phone
(918) 458-0663
Fax
(918) 428-0780
NPI assigned
Aug 23, 2006
Last updated
Jul 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Authorized official

Name
Justin Carter
Title
Authorized Official/President
Phone
(405) 947-7700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 4153 OK Primary

Addresses

Primary practice location

200 Harris Cir Ste a
Tahlequah, OK 74464-8899

Mailing address

7725 W Reno Ave Ste 332
Oklahoma City, OK 73127-9799
Phone (405) 947-7700

Other names 1

  • Carter Healthcare & Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161028000070 OK Part A Provider - Hospice 9234417163 Practice locations: Tahlequah, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245347632. Details of each certification follow.

Hospice certification: CCN 371616

Legal name
CARTER HEALTHCARE HOSPICE OF EAST OKLAHOMA LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 15, 2003
Last certification
May 25, 2022
Ownership / control type
Proprietary - Individual
Organization structure
LLCProprietary
Incorporated
Dec 1, 2015 in OK
Enrollment address
200 E. Harris Circle
Suite a
Tahlequah, OK 74464-8899

Care Compare: Hospice

Medicare Care Compare
Listed as
Carter Healthcare Hospice of East Oklahoma, LLCCCN 371616 · All quality measures
Ownership
For-Profit
Certified
Jul 15, 2003
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Member of 1

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

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Carter Healthcare of Southwest Oklahoma, LLC Organization, Oklahoma City, OK LLC 5% Or Greater Direct Ownership Interest Nov 1, 2016 100%
Robert L Peters Individual Operational/Managerial ControlDirector of Billing Mar 1, 2017 33%
Cynthia Carter Individual 5% Or Greater Indirect Ownership InterestBoard Member Sep 27, 2022 9.71%
Justin Carter Individual 5% Or Greater Indirect Ownership InterestPresident Sep 27, 2022 90.29%
Corporate OfficerPresident Sep 27, 2022 100%
Corporate DirectorPresident Sep 27, 2022 100%
W-2 Managing EmployeePresident Sep 27, 2022 100%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 5

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

Change-of-ownership history 2

DateEventCounterparty
Nov 1, 2016 Change of OwnershipThis provider was the buyer Carter HealthcareCCN 371616, OK, NPI 1245347632
Nov 1, 2016 Change of OwnershipThis provider was the seller Carter Healthcare Hospice of East Oklahoma LLCCCN 371616, OK, NPI 1245347632

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751414400000",
    "number": "1245347632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7725 W RENO AVE STE 332",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731279799",
            "telephone_number": "405-947-7700",
            "fax_number": "405-947-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HARRIS CIR STE A",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744648899",
            "telephone_number": "918-458-0663",
            "fax_number": "918-428-0780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARTER HEALTHCARE HOSPICE OF EAST OKLAHOMA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL/PRESIDENT",
        "authorized_official_telephone_number": "405-947-7700"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "OK",
            "license": "4153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carter Healthcare & Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tahlequah, OK

Sources for this page

Verify at the official NPI Registry.