Alva Hospital Authority
Organization Active NPI Rural Health Clinic/Center · Alva, OK
NPI 1497945851 · NPPES record last updated Aug 27, 2025
Key facts
- NPI
- 1497945851
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- ALVA HOSPITAL AUTHORITY
- 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
- Organization subpart
- Yes
- Parent organization (as reported)
- SHARE MEDICAL CENTER
Authorized official
- Name
- Mrs. Kandice Hospital Allen
- Title
- Ceo
- Phone
- (580) 327-2800
Owners & managing parties with NPI records 2
-
Scott W Burk, MD
Owned or controlled facilities with NPI records 1
Other NPIs on the same Medicare enrollment 5
Other NPIs with the same Medicare PAC ID 1
Related certifications (CCN) 1
Facilities with the same owner 1
Practitioners 16
-
Bryan Nutter, ARNP
-
Scott W Burk, MD
-
Steve M Madrid, PA
-
Jennifer Nichols, APRN
-
Addison Pierce Roberts, D.O.
-
Brian W. Cook, D.O.
-
Krystal Fallen Elliott, DNP, APRN, FNP-C
-
Jessica Rayleen Jones, APRN-CNP
-
Emily E Nayar, P.A.-C
-
Ryan Michael Sand, APRN-CNP
-
Brady Don Reed, CRNA
-
John Chris Hummel, M.D
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OK
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
- Other · Non-profit
- Incorporated
- Oct 1, 1968 in OK
- Enrollment address
- 410 4TH St
Ste J
Alva, OK 73717-2363 - Related CCNs
- 371341
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| Gregory Bowman |
Corporate Director | Apr 1, 2021 | |
| Kenneth Brown |
Corporate Director | Jul 1, 2015 | |
| Halah R Simon |
Corporate Director | Jun 1, 2013 | |
| Scott W Burk |
Corporate Director | Nov 1, 2021 | |
| Kandice K Allen |
Corporate Officer |
Jul 1, 2011 | |
| W-2 Managing Employee |
Jul 1, 2011 | ||
| Alva Hospital Authority |
Operational/Managerial Control | Oct 1, 1968 | 100% |
| Jay Randels |
Corporate Director | Jul 1, 2018 | |
| Jason Gaisford |
Corporate Director | Oct 1, 2005 | |
| Chris Lauderdale |
W-2 Managing Employee |
Aug 4, 2020 | |
| Derek Hannaford |
Corporate Director | Sep 20, 2021 |
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Share Medical Center - West End Clinic |
Rural health clinic | Operational/Managerial Control (100%) | Oct 1, 1968 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Part of
- Share Health Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | OK | ||
| Clinic/Center | 261Q00000X | |||
| Primary Care Clinic/Center | 261QP2300X | |||
| Rural Health Clinic/Center | 261QR1300X | Yes |
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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100699830L | Medicaid | OK |
Other names
- SMC Downtown Clinic
- SMC Physicians Clinic
Other providers in Alva, OK
- Alva Chiropractic Clinic, P.L.L.C.
- Alva EMS
- Alva Health and Wellness PLLC
- Alva Hospital Authority
- Alva Hospital Authority
- Alva Hospital Authority
- Alva Hospital Authority
- Alva Hospital Authority
- Karmen Ann Andrews
- Michelle Baird
All providers in Alva, OK · Rural Health Clinic/Center in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 27, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.