NPIMap

Organization Active NPI

Roger Mills County Hospital Authority

  • Rural Health Clinic/Center
  • Cheyenne, OK
National Provider Identifier
1407950447
Registry record updated Dec 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ROGER MILLS COUNTY HOSPITAL AUTHORITY
Practice address
101 FK Buster Ave
Cheyenne, OK 73628-0490
Phone
(580) 497-3333
Fax
(580) 497-2778
NPI assigned
Sep 11, 2006
Last updated
Dec 5, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
ROGER MILLS COUNTY HOSPITAL AUTHORITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 5, 2017

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

Authorized official

Name
Ms. Cynthia E Duncan
Title
Ceo
Phone
(580) 497-3336

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

101 FK Buster Ave
Cheyenne, OK 73628-0490

Mailing address

PO Box 490
Cheyenne, OK 73628-0490
Phone (580) 497-3333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080910000682 OK Part A Provider - Rural Health Clinic 7113827403 Practice locations: Cheyenne, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407950447. Details of each certification follow.

Rural health clinic certification: CCN 373999

Legal name
ROGER MILLS COUNTY HOSPITAL AUTHORITY
Doing business as
BUSTER RURAL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 16, 1994
Last certification
Mar 31, 2021
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
101 FK Buster Ave
Cheyenne, OK 73628-0490
Related CCNs
371303

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

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Roger Mills County Hospital3 organizations share this tax ID, including this one
Part of
Roger Mills County Hospital

Other organizations with this tax ID 2

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

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Cynthia E Duncan Individual Corporate OfficerCeo Jul 12, 2006 100%
W-2 Managing EmployeeCeo Jul 21, 2015 100%
Randy O'Neal Individual Corporate Director May 10, 2021
Janet Barton Individual W-2 Managing EmployeeCeo Jul 21, 2015 100%
Operational/Managerial ControlOffice Manager Dec 29, 2015 100%
Roger Mills County Hospital Authority Organization, Cheyenne, OK Operational/Managerial Control Mar 14, 1994

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 2

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

FacilityTypeRoleSince
Roger Mills Memorial HospitalCheyenne, OK, CCN 371303 Hospital Operational/Managerial Control Apr 1, 1999
Roger Mills Memorial HospitalCheyenne, OK, CCN 37Z303 Hospital Operational/Managerial Control Apr 1, 1999

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 1

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512432000000",
    "number": "1407950447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "CHEYENNE",
            "state": "OK",
            "postal_code": "736280490",
            "telephone_number": "580-497-3333",
            "fax_number": "580-497-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 FK BUSTER AVE",
            "city": "CHEYENNE",
            "state": "OK",
            "postal_code": "736280490",
            "telephone_number": "580-497-3333",
            "fax_number": "580-497-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGER MILLS COUNTY HOSPITAL AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROGER MILLS COUNTY HOSPITAL AUTHORITY",
        "enumeration_date": "2006-09-11",
        "last_updated": "2017-12-05",
        "status": "A",
        "authorized_official_last_name": "DUNCAN",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "580-497-3336",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, OK

Sources for this page

Verify at the official NPI Registry.