NPIMap

Organization Active NPI

Acadiana Healthcare of Oklahoma, Inc.

Doing business as Johnston Memorial Hospital

  • Critical Access Hospital
  • Tishomingo, OK
National Provider Identifier
1356544399
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
ACADIANA HEALTHCARE OF OKLAHOMA, INC.
Doing business as
Johnston Memorial Hospital
Practice address
1000 S Byrd St
Tishomingo, OK 73460-3265
Phone
(580) 371-2327
Fax
(580) 371-2127
NPI assigned
Jun 7, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Robert R. Hicks
Title
Ceo
Phone
(580) 371-2327

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X NU Primary

Addresses

Primary practice location

1000 S Byrd St
Tishomingo, OK 73460-3265

Mailing address

3555 NW 58TH St
Suite 200
Oklahoma City, OK 73112-4707
Phone (580) 371-2327

Other names 1

  • Johnston Memorial Hospital Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Acadiana Healthcare of Oklahoma Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356544399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 NW 58TH ST",
            "address_2": "SUITE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124707",
            "telephone_number": "580-371-2327",
            "fax_number": "580-371-2127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S BYRD ST",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "734603265",
            "telephone_number": "580-371-2327",
            "fax_number": "580-371-2127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACADIANA HEALTHCARE OF OKLAHOMA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "580-371-2327",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Johnston Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tishomingo, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.