NPIMap

Organization Active NPI

Integris Hospice, Inc

  • Community Based Hospice Care Agency
  • Oklahoma City, OK
National Provider Identifier
1295736866
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
4064 Issued in OK
Legal business name
INTEGRIS HOSPICE, INC
Practice address
13920 Quailbrook Dr
Oklahoma City, OK 73134-1718
Phone
(405) 751-5557
NPI assigned
Aug 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2019

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

Authorized official

Name
Brent Davis
Title
Vice President
Phone
(405) 949-3774

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 4064 OK Primary

Addresses

Primary practice location

13920 Quailbrook Dr
Oklahoma City, OK 73134-1718

Mailing address

PO Box 96014
Oklahoma City, OK 73196-0514
Phone (405) 848-8884

Other names 1

  • Integris Hospice House Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090923000194 OK Part A Provider - Hospice 4688720238 Practice locations: Oklahoma City, OK

Other NPIs with the same Medicare PAC ID 1

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

Hospice certification: CCN 371549

Legal name
INTEGRIS HOSPICE, INC.
Doing business as
INTEGRIS HOSPICE HOUSE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Sep 24, 1996
Last certification
Sep 30, 2020
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 14, 2009 in OK
Enrollment address
13920 Quailbrook Dr
Oklahoma City, OK 73134-1718

National Provider Directory

National Provider Directory
Tax ID family
Integris Hospice Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

5710 NW 130th St
#100
Oklahoma City, OK 73142
Phone (405) 848-8884

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Linda Merkey Individual Corporate DirectorBoard Member Jan 1, 1998
Ashley N Muckala Individual Corporate Director Jul 1, 2023
Donna M Wallace Individual Corporate Officer Sep 1, 2023
W-2 Managing Employee Sep 1, 2023
Lydia Welch Individual Corporate Director Jul 1, 2023
Michael L Weed Individual Corporate Director Jul 1, 2020
Casey Ahlden Individual Corporate Director Jan 1, 2023
Integris Health Inc Organization, Oklahoma City, OK Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jul 14, 2009 100%
Brad Ferguson Individual Corporate DirectorBoard Member Jan 1, 2008
Melinda Warren Individual Corporate DirectorBoard Member Jan 1, 2006
Michelle Powers Individual Corporate Director Jun 1, 2023
Alison Fink Individual Corporate Director Jun 1, 2023
Avilla Williams Individual Corporate Director Jun 1, 2023
Timothy Pehrson Individual Corporate DirectorCeo/Board Member Aug 1, 2018
W-2 Managing EmployeeCeo/Board Member Aug 1, 2018

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
Integris Hospice HouseOklahoma City, OK, CCN 371513 Hospice 5% Or Greater Direct Ownership Interest (100%) Sep 14, 1990

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 30

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

View all 30

Care Compare: Hospice

Medicare Care Compare
Listed as
Integris Hospice HouseCCN 371549
Ownership
For-Profit
Certified
Sep 24, 1996
Medicare certification status
ActiveFrom the Provider of Services file

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
37D1059731Integris Hospice House13920 Quailbrook Drive, Oklahoma City, OK 73134Certificate of waiverOct 4, 2026

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558569600000",
    "number": "1295736866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96014",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731960514",
            "telephone_number": "405-848-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13920 QUAILBROOK DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731341718",
            "telephone_number": "405-751-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRIS HOSPICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2019-05-23",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "405-949-3774"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "OK",
            "license": "4064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integris Hospice House",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Integris Hospice House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.