NPIMap

Organization Active NPI

Leflore County Hospital Authority

Doing business as Eastern Oklahoma Medical Center

  • Critical Access Hospital
  • Poteau, OK
National Provider Identifier
1396767158
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
2174 Issued in OK
Legal business name
LEFLORE COUNTY HOSPITAL AUTHORITY
Doing business as
Eastern Oklahoma Medical Center
Practice address
105 Wall Street
Poteau, OK 74953-4405
Phone
(918) 635-3309
Fax
(918) 635-3308
NPI assigned
Jul 24, 2006
Last updated
May 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Authorized official

Name
Tiffany B Griffis
Title
Ceo
Phone
(918) 635-3441

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 37-U040 OK
Medicare Defined Swing Bed Hospital Unit 275N00000X 2174 OK
General Acute Care Hospital 282N00000X 370040 OK
Critical Access Hospital 282NC0060X 2174 OK Primary

Addresses

Primary practice location

105 Wall Street
Poteau, OK 74953-4405

Mailing address

105 Wall St
Poteau, OK 74953-4433
Phone (918) 635-3309

Other names 1

  • Eastern Oklahoma Medical Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 12/31/2040 Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150519002501 OK Part A Provider - Critical Access Hospital 7719916956 Practice locations: Poteau, OK
O20150520000247 OK Part A Provider - Critical Access Hospital 7719916956 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Poteau, OK

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1396767158. Details of each certification follow.

Hospital certification: CCN 37Z337

Legal name
LEFLORE COUNTY HOSPITAL AUTHORITY
Doing business as
EASTERN OKLAHOMA MEDICAL CENTER
Organization structure
OtherNon-profit
Incorporated
Jul 6, 1977 in OK
Enrollment address
105 Wall St
Poteau, OK 74953-4433
Other Hospital Practice Location

Hospital certification: CCN 371337

Legal name
LEFLORE COUNTY HOSPITAL AUTHORITY
Doing business as
EASTERN OKLAHOMA MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 22, 2016
Last certification
Nov 2, 2023
Beds
25
Ownership / control type
Local
Organization structure
OtherNon-profit
Incorporated
Jul 6, 1977 in OK
Enrollment address
105 Wall St
Poteau, OK 74953-4433
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Eastern Oklahoma Medical CenterCCN 371337 · All quality measures
Overall star rating
4 of 5
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

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
Brandon Bullard Individual Corporate OfficerChief Financial Officer Jun 22, 2021
Cassie Lee Hempen Individual W-2 Managing Employee Apr 10, 2021
Carl Robert Reed Individual Corporate OfficerBoard Secretary May 1, 2014
Corporate DirectorSecretary of the Board May 1, 2014
Robert Carter Individual Corporate DirectorChief Executive Officer Jul 2, 2018
Leflore County Hospital Authority Organization, Poteau, OK Operational/Managerial Control Apr 1, 2015
Joe Mode Individual Corporate OfficerTreasurer Jan 1, 2022
Operational/Managerial ControlBoard Member Jul 1, 2021
Jerry Andrews Individual Corporate OfficerChairman of the Board Jan 1, 2022
Corporate DirectorChairman of the Board Jul 1, 2010
Bradley Dedmon Individual Operational/Managerial ControlBoard Member Jan 1, 2021
Logan Hayes Individual Corporate OfficerCoo May 23, 2023
Garry Ivey Individual OtherBoard Member Jan 1, 2021
Darla Ford Individual W-2 Managing EmployeeChief Nursing Officer Jan 1, 2020
Tiffany B Griffis Individual Corporate OfficerCeo Aug 28, 2023
Audrey Balentine Individual Operational/Managerial ControlBoard Member Jul 19, 2019

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Family Medical ClinicPoteau, OK, CCN 373479 Rural health clinic Operational/Managerial Control Jan 1, 2014
Heavener Medical ClinicHeavener, OK, CCN 373480 Rural health clinic Operational/Managerial Control Jan 1, 2014
Cavanal Medical ClinicPoteau, OK, CCN 378536 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2019

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Practitioners 62

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.

View all 62

Affiliated clinicians 99

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 99

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746662400000",
    "number": "1396767158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 WALL ST",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749534433",
            "telephone_number": "918-635-3309",
            "fax_number": "918-635-3308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WALL STREET",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749534405",
            "telephone_number": "918-635-3309",
            "fax_number": "918-635-3308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEFLORE COUNTY HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A",
        "authorized_official_last_name": "GRIFFIS",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "918-635-3441"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "OK",
            "license": "37-U040",
            "primary": false
        },
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "OK",
            "license": "2174",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "OK",
            "license": "370040",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "OK",
            "license": "2174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "12/31/2040",
            "affiliation": "N",
            "endpointDescription": "Administrative user",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Hospital",
            "address_1": "105 Wall Street",
            "city": "Poteau",
            "state": "OK",
            "country_code": "US",
            "postal_code": "749534405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Eastern Oklahoma Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eastern Oklahoma Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poteau, OK

Sources for this page

Verify at the official NPI Registry.