NPIMap

Organization Active NPI

Stillwater Medical Center Authority

Doing business as Stillwater Medical Center

  • Skilled Nursing Facility
  • Stillwater, OK
National Provider Identifier
1407828908
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
2272 Issued in OK
Legal business name
STILLWATER MEDICAL CENTER AUTHORITY
Doing business as
Stillwater Medical Center
Practice address
1323 W 6TH Ave
Stillwater, OK 74074-4306
Phone
(405) 372-1480
NPI assigned
Feb 7, 2006
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
Jerry Moeller
Title
Ceo
Phone
(405) 742-5701

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 2272 OK Primary

Addresses

Primary practice location

1323 W 6TH Ave
Stillwater, OK 74074-4306

Mailing address

1323 W 6TH Ave
Stillwater, OK 74074-4306
Phone (405) 372-1480

Other names 1

  • Stillwater Medical Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Phillip Newman28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407828908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1323 W 6TH AVE",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744306",
            "telephone_number": "405-372-1480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1323 W 6TH AVE",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744306",
            "telephone_number": "405-372-1480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILLWATER MEDICAL CENTER AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOELLER",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "405-742-5701"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OK",
            "license": "2272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stillwater Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stillwater, 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.