NPIMap

Organization Active NPI

Alva Hospital Authority

Doing business as SMC Downtown Clinic

  • Rural Health Clinic/Center
  • Alva, OK
National Provider Identifier
1497945851
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ALVA HOSPITAL AUTHORITY
Doing business as
SMC Downtown Clinic
SMC Physicians Clinic
Practice address
410 4TH St Ste J
Alva, OK 73717-2363
Phone
(580) 430-3333
Fax
(580) 430-3305
NPI assigned
Jul 31, 2007
Reactivated
Feb 28, 2020
Last updated
Aug 27, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SHARE MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Authorized official

Name
Mrs. Kandice Hospital Allen
Title
Ceo
Phone
(580) 327-2800

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X OK
Clinic/Center 261Q00000X
Primary Care Clinic/Center 261QP2300X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

410 4TH St Ste J
Alva, OK 73717-2363

Mailing address

800 Share Dr
Alva, OK 73717-3618
Phone (580) 430-3366

Other names 2

  • SMC Downtown Clinic Doing business as
  • SMC Physicians Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040514000014 OK Part B Supplier - Clinic/Group Practice 5597755306 Receives reassigned benefits from 26 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Alva, OK
O20220505001885 OK Part A Provider - Rural Health Clinic 5597755306 Practice locations: Alva, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497945851. Details of each certification follow.

Rural health clinic certification: CCN 378557

Legal name
ALVA HOSPITAL AUTHORITY
Doing business as
CODE QUICK LLC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 11, 2023
Last certification
Jan 11, 2023
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Incorporated
Oct 1, 1968 in OK
Enrollment address
410 4TH St
Ste J
Alva, OK 73717-2363
Related CCNs
371341

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

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Part of
Share Health Center

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Gregory Bowman Individual Corporate Director Apr 1, 2021
Kenneth Brown Individual Corporate Director Jul 1, 2015
Halah R Simon Individual Corporate Director Jun 1, 2013
Scott W Burk Individual Corporate Director Nov 1, 2021
Kandice K Allen Individual Corporate OfficerCeo Jul 1, 2011
W-2 Managing EmployeeCeo Jul 1, 2011
Alva Hospital Authority Organization, Alva, OK Operational/Managerial Control Oct 1, 1968 100%
Jay Randels Individual Corporate Director Jul 1, 2018
Jason Gaisford Individual Corporate Director Oct 1, 2005
Chris Lauderdale Individual W-2 Managing EmployeeCfo Aug 4, 2020
Derek Hannaford Individual Corporate Director Sep 20, 2021

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 1

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

FacilityTypeRoleSince
Share Medical Center - West End ClinicAlva, OK, CCN 378543 Rural health clinic Operational/Managerial Control (100%) Oct 1, 1968

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.

Practitioners & affiliated clinicians

Practitioners 10

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": "1185840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756252800000",
    "number": "1497945851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SHARE DR",
            "city": "ALVA",
            "state": "OK",
            "postal_code": "737173618",
            "telephone_number": "580-430-3366",
            "fax_number": "580-430-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 4TH ST STE J",
            "city": "ALVA",
            "state": "OK",
            "postal_code": "737172363",
            "telephone_number": "580-430-3333",
            "fax_number": "580-430-3305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALVA HOSPITAL AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHARE MEDICAL CENTER",
        "enumeration_date": "2007-07-31",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "deactivation_date": "2020-02-25",
        "reactivation_date": "2020-02-28",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "KANDICE",
        "authorized_official_middle_name": "HOSPITAL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "580-327-2800",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OK",
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMC Downtown Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SMC Downtown Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SMC Physicians Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alva, OK

Sources for this page

Verify at the official NPI Registry.