Jackson County Memorial Hospital Skilled Nursing Facility

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2206 Issued in OK

Legal business name

JACKSON COUNTY MEMORIAL HOSPITAL SKILLED NURSING FACILITY

Practice address

1200 E Pecan St
Altus, OK 73521-6141

Phone

(580) 379-5000

Fax

(580) 379-5509

NPI assigned

Jun 8, 2006

Last updated

Oct 6, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Steve Hartgraves

Title

President/Ceo

Phone

(580) 379-5500

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665014400000",
    "number": "1356382899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E PECAN ST",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735216141",
            "telephone_number": "580-379-5000",
            "fax_number": "580-379-5509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E PECAN ST",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735216141",
            "telephone_number": "580-379-5000",
            "fax_number": "580-379-5509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON COUNTY MEMORIAL HOSPITAL SKILLED NURSING FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A",
        "authorized_official_last_name": "HARTGRAVES",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "580-379-5500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OK",
            "license": "2206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100699350A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackson County Memorial Hospital Authority (Jackson County Memorial Hospital Hospice)
• Jackson County Memorial Hospital Authority (JCMH Medical Clinic)
• Jackson County Memorial Hospital Authority (JCMH Pediatric Clinic)
• Jackson County Memorial Hospital Authority (Jackson County Memorial Hospital Home Care)
• Jackson County Memorial Hospital Authority (JCMH Women's Health Associates)
• Amber Dawn Jackson, MS, CCC-SLP
• Carl Edward Jackson, M.S. LPC
• Sara Lafawn Jackson, M.S. LPC
• James H Burns DC PC
• Taylor Nicole January, MED, LPC

• Skilled Nursing Facility in Altus, OK
• Providers in Altus, OK by specialty
• Skilled Nursing Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.