Organization Active NPI

Healthback of Central Oklahoma, Inc.

Doing business as HealthBack of Purcell

  • Home Health Agency
  • Purcell, OK
National Provider Identifier
1417910050
Registry record updated Mar 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
7434 Issued in OK
Legal business name
HEALTHBACK OF CENTRAL OKLAHOMA, INC.
Doing business as
HealthBack of Purcell
Practice address
519 W Delaware St
Purcell, OK 73080-5242
Phone
(405) 527-0027
Fax
(405) 527-1423
NPI assigned
Apr 6, 2006
Last updated
Mar 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2015

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

Authorized official

Name
Mr. Michael A. Curtis
Title
Cfo
Phone
(405) 842-1700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 7434 OK Primary

Addresses

Primary practice location

519 W Delaware St
Purcell, OK 73080-5242

Mailing address

16211 N May Ave
Edmond, OK 73013-8871
Phone (405) 842-1700

Other identifiers 1

IdentifierTypeStateIssuer
100263010AMedicaidOK

Other names 1

  • HealthBack of Purcell Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory

Locations

2600 Arlington St
#B
Ada, OK 74820
Phone (580) 332-4888

2005 W Wrangler Blvd
#B
Seminole, OK 74868
Phone (405) 382-0223

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Sep 9, 2022 Change of OwnershipThis provider was the seller Vitalcaring Group Home Health - PurcellCCN 377520, OK, NPI 1487390241

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427068800000",
    "number": "1417910050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16211 N MAY AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730138871",
            "telephone_number": "405-842-1700",
            "fax_number": "405-767-1695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 W DELAWARE ST",
            "city": "PURCELL",
            "state": "OK",
            "postal_code": "730805242",
            "telephone_number": "405-527-0027",
            "fax_number": "405-527-1423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHBACK OF CENTRAL OKLAHOMA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2015-03-23",
        "status": "A",
        "authorized_official_last_name": "CURTIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "405-842-1700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OK",
            "license": "7434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100263010A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthBack of Purcell",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Purcell, OK

Sources for this page

Verify at the official NPI Registry.