NPIMap

Organization Active NPI

Muskogee Regional Medical Center LLC

  • Home Health Agency
  • Muskogee, OK
National Provider Identifier
1417099409
Registry record updated Dec 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
2177 Issued in OK
Legal business name
MUSKOGEE REGIONAL MEDICAL CENTER LLC
Practice address
300 Rockefeller Dr
Muskogee, OK 74401-5075
Phone
(918) 682-5501
Fax
(918) 684-2552
NPI assigned
Feb 13, 2007
Organization subpart
Yes
Parent organization
MUSKOGEE REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 30, 2008

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

Authorized official

Name
Daniel S Slipkovich
Title
Ceo
Phone
(615) 764-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 2177 OK Primary

Addresses

Primary practice location

300 Rockefeller Dr
Muskogee, OK 74401-5075

Mailing address

300 Rockefeller Dr
Muskogee, OK 74401-5075
Phone (918) 682-5501

Other identifiers 1

IdentifierTypeStateIssuer
100700630BMedicaidOK

Other names 1

  • Muskogee Reg Med Ctr Home Health Ser Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Muskogee Regional Medical Center LLC4 organizations share this tax ID, including this one
Part of
Muskogee Regional Medical Center

Other organizations with this tax ID 3

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

Locations

3520 Chandler Rd
Muskogee, OK 74403
Phone (918) 478-6005

151 Eco Friendly Dr
Slp Ctr
Muskogee, OK 74401
Phone (918) 684-5600

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230595200000",
    "number": "1417099409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 ROCKEFELLER DR",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744015075",
            "telephone_number": "918-682-5501",
            "fax_number": "918-684-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ROCKEFELLER DR",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744015075",
            "telephone_number": "918-682-5501",
            "fax_number": "918-684-2552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUSKOGEE REGIONAL MEDICAL CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MUSKOGEE REGIONAL MEDICAL CENTER",
        "enumeration_date": "2007-02-13",
        "last_updated": "2008-12-30",
        "status": "A",
        "authorized_official_last_name": "SLIPKOVICH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "615-764-3000"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OK",
            "license": "2177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100700630B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Muskogee Reg Med Ctr Home Health Ser",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Muskogee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2008; 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.