NPIMap

Organization Active NPI

Coal County General Hospital

Doing business as ABC Medical Clinic of Holdenville

  • Family Medicine Physician
  • McAlester, OK
National Provider Identifier
1245938497
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COAL COUNTY GENERAL HOSPITAL
Doing business as
Eastern Oklahoma Health Clinic of McAlester
Practice address
1308 E Carl Albert Pkwy
McAlester, OK 74501-5236
Phone
(918) 423-7191
Fax
(918) 426-7625
NPI assigned
Feb 17, 2023
Last updated
Sep 23, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
COAL COUNTY GENERAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Authorized official

Name
Trent Bourland
Title
Ceo
Phone
(580) 927-2327

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Health Service Clinic/Center 261QH0100X
Primary Care Clinic/Center 261QP2300X
Rural Health Clinic/Center 261QR1300X
Family Nurse Practitioner 363LF0000X
Primary Care Nurse Practitioner 363LP2300X
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1308 E Carl Albert Pkwy
McAlester, OK 74501-5236

Mailing address

PO Box 326
Coalgate, OK 74538-0326
Phone (580) 927-2327

Other identifiers 1

IdentifierTypeStateIssuer
100774650IMedicaidOK

Other names 2

  • ABC Medical Clinic of Holdenville Former legal business name
  • Eastern Oklahoma Health Clinic of McAlester Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180731001666 OK Part A Provider - Rural Health Clinic 8022901396 2 other NPIs on this enrollment
Practice locations: McAlester, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245938497. Details of each certification follow.

Rural health clinic certification: CCN 378513

Legal name
COAL COUNTY GENERAL HOSPITAL
Doing business as
EASTERN OKLAHOMA HEALTH CLINIC OF MCALESTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 1, 2018
Last certification
May 8, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Aug 1, 2004 in OK
Enrollment address
1308 E Carl Albert Pkwy
Ste a
McAlester, OK 74501-5236
Related CCNs
371319

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

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2114389Eastern Oklahoma Health Clinic of McAlester1308 East Carl Albert Parkway, McAlester, OK 74501Certificate of waiverJun 12, 2028

National Provider Directory

National Provider Directory
Tax ID family
Coal County General Hospital3 organizations share this tax ID, including this one
Part of
Coal County General Hospital

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/coalcgh-a055a746

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
Chris Martin Individual Corporate Officer May 19, 2025
W-2 Managing EmployeeChief Executive Officer May 19, 2025
Kevin Haney Individual Corporate DirectorDirector Feb 22, 2021
Jerad Gearhart Individual Corporate DirectorDirector Sep 27, 2021
Johnny Sandmann Individual Corporate DirectorDirector Sep 27, 2021

NPI Registry JSON

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

{
    "created_epoch": "1676592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790121600000",
    "number": "1245938497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 326",
            "city": "COALGATE",
            "state": "OK",
            "postal_code": "745380326",
            "telephone_number": "580-927-2327",
            "fax_number": "580-927-2439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 E CARL ALBERT PKWY",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745015236",
            "telephone_number": "918-423-7191",
            "fax_number": "918-426-7625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COAL COUNTY GENERAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COAL COUNTY GENERAL HOSPITAL",
        "enumeration_date": "2023-02-17",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A",
        "authorized_official_last_name": "BOURLAND",
        "authorized_official_first_name": "TRENT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "580-927-2327"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100774650I",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ABC Medical Clinic of Holdenville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eastern Oklahoma Health Clinic of McAlester",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ABC Medical Clinic of Holdenville",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in McAlester, OK

Sources for this page

Verify at the official NPI Registry.