NPIMap

Organization Active NPI

Weatherford Hospital Authority

Doing business as Weatherford Regional Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Weatherford, OK
National Provider Identifier
1285709998
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
2219 Issued in OK
Legal business name
WEATHERFORD HOSPITAL AUTHORITY
Doing business as
Weatherford Regional Hospital
Practice address
3701 E Main St
Weatherford, OK 73096-3309
Phone
(580) 772-5551
Fax
(580) 774-0964
NPI assigned
Nov 21, 2006
Last updated
Feb 2, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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 2219 OK Primary

Addresses

Primary practice location

3701 E Main St
Weatherford, OK 73096-3309

Mailing address

3701 E Main St
Weatherford, OK 73096-3309
Phone (580) 772-5551

Other names 1

  • Weatherford Regional Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090812000539 OK Part A Provider - Critical Access Hospital 9032021837 Practice locations: Weatherford, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285709998. Details of each certification follow.

Hospital certification: CCN 37Z323

Legal name
WEATHERFORD HOSPITAL AUTHORITY
Doing business as
WEATHERFORD REGIONAL HOSPITAL
Organization structure
OtherNon-profit
Incorporated
Aug 17, 2007 in OK
Enrollment address
3701 E Main St
Weatherford, OK 73096-3309
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Weatherford Hosp Auth6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Faye Kelln Henson Individual Corporate DirectorTrustee Jan 25, 2016
Brad Berrong Individual Corporate DirectorChairman Jun 4, 2009
Georganna Buss Individual Contracted Managing EmployeeCfo May 14, 2018
Corporate OfficerChief Financial Officer May 14, 2018
Weatherford Hospital Authority Organization, Weatherford, OK Operational/Managerial Control Jun 4, 2007
Doug Misak Individual Corporate DirectorVice Chairman Jan 25, 2016

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Weatherford Regional HospitalWeatherford, OK, CCN 371323 Hospital Operational/Managerial Control Jun 4, 2007

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 1

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

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 5

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": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612224000000",
    "number": "1285709998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 E MAIN ST",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "730963309",
            "telephone_number": "580-772-5551",
            "fax_number": "580-774-0964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 E MAIN ST",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "730963309",
            "telephone_number": "580-772-5551",
            "fax_number": "580-774-0964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEATHERFORD HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "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": "2219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Weatherford Regional Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Weatherford Regional Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Weatherford, OK

Sources for this page

Verify at the official NPI Registry.