NPIMap

Organization Active NPI

State of Oklahoma

  • Community/Behavioral Health Agency
  • Alva, OK
National Provider Identifier
1437222734
Registry record updated Feb 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
STATE OF OKLAHOMA
Practice address
604 Choctaw
Northwest Center for Behavioral Health
Alva, OK 73717
Phone
(580) 327-1112
Fax
(580) 327-3067
NPI assigned
Nov 16, 2006
Last updated
Feb 27, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2013

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

Authorized official

Name
Trudy Hoffman
Title
Executive Director
Phone
(580) 571-3233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

604 Choctaw
Northwest Center for Behavioral Health
Alva, OK 73717

Mailing address

1222 10TH St Suite 211
Northwest Center for Behavioral Health
Woodward, OK 73801-3156
Phone (580) 571-3217

Other identifiers 1

IdentifierTypeStateIssuer
100706980AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031125000846 OK Part B Supplier - Clinic/Group Practice 4486558962 Receives reassigned benefits from 175 practitioners
32 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Alva, OK; Woodward, OK; Tulsa, OK; Stigler, OK; Norman, OK; McAlester, OK; Lawton, OK; Kingfisher, OK…

Other NPIs on the same Medicare enrollment 23

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

View all 23

National Provider Directory

National Provider Directory
Tax ID family
Carl Albert Community M141 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

604 Choctaw St
Alva, OK 73717
Phone (580) 327-1112

Practitioners & affiliated clinicians

Practitioners 7

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": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361923200000",
    "number": "1437222734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 10TH ST SUITE 211",
            "address_2": "NORTHWEST CENTER FOR BEHAVIORAL HEALTH",
            "city": "WOODWARD",
            "state": "OK",
            "postal_code": "738013156",
            "telephone_number": "580-571-3217",
            "fax_number": "580-256-8609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 CHOCTAW",
            "address_2": "NORTHWEST CENTER FOR BEHAVIORAL HEALTH",
            "city": "ALVA",
            "state": "OK",
            "postal_code": "73717",
            "telephone_number": "580-327-1112",
            "fax_number": "580-327-3067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF OKLAHOMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2013-02-27",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "TRUDY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "580-571-3233"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100706980A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alva, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.