Integris Health Ponca City Hospital Inc
Organization Active NPI General Acute Care Hospital · Ponca City, OK
NPI 1548047616 · NPPES record last updated Dec 21, 2023
Key facts
- NPI
- 1548047616
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Acute Care Hospital 282N00000X
- Legal business name
- INTEGRIS HEALTH PONCA CITY HOSPITAL INC
- Practice address
- 1900 N 14TH St
Ponca City, OK 74601-2035 - Phone
- (580) 765-3321
- NPI assigned
- Sep 12, 2023
- Organization subpart
- No
Authorized official
- Name
- Donna Wallace
- Title
- Assistant Treasurer
- Phone
- (636) 359-4890
Other NPIs with the same Medicare PAC ID 2
Subparts reporting this organization as parent 2
Corporate family (same tax ID) 2
Related certifications (CCN) 2
Facilities with the same owner 30
Practitioners 55
-
Taelor Baetz, PA
-
Neal Ross Brockbank, D.O.
-
Tangra Lea Broge, MD
-
Eva Case, ARNP
-
Randell B Chapman, M.D.
-
James Corbett, PA-C
-
Tammy Lynn Dexter, CNM
-
Amanda Dorough, D.O.
-
Kari L Elliott, DNP, CPNP-PC, AE-C
-
Christopher Greenhagen, PA-C
-
Christen Denise Ground, D.O.
-
John Ground, DO
-
Gerald Ray Hale, D.O.
-
Ashley Hesson, APRN-CNP
-
Lindsey Hester, APRN, FNP, ENP
-
John W Holden, M.D.
-
Victoria Renee Keeton, D.O.
-
Jenna-Lyn Klufa, NP-C
-
Taylor Lewis, APRN-CNP
Affiliated clinicians 155
-
Kimberly Abernathy, APRN-CNP
-
Amy Kathryn Alberty, NP-C
-
Rafel Alvarez, D.O.
-
Sean Anderson, AGACNP-BC
-
Vicente Karlos Arcos, M.D.
-
Surya M Artham, MD, MPH
-
Taelor Baetz, PA
-
Logan Batley, APRN-CNP
-
Bruce Earl Baugher, D.O.
-
Billy C Beets Jr., M.D.
-
Sarah Christine Ben, PA-C
-
Paul A. Briggs, M.D.
-
Idayat Brimah, MD
-
Neal Ross Brockbank, D.O.
-
Kelsey Burnett, PA-C
-
Eva Case, ARNP
-
Randell B Chapman, M.D.
Medicare Care Compare: Hospital
- Listed as
- Integris Health Ponca City
- Overall star rating
- ★★☆☆☆ 2 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Other
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Hospital certification: CCN 370006
- Legal name
- INTEGRIS HEALTH PONCA CITY HOSPITAL INC
- Doing business as
- INTEGRIS HEALTH PONCA CITY HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Oct 21, 1970
- Last certification
- Apr 20, 2023
- Beds
- 140
- Ownership / control type
- Other
- Most recent change of ownership
- Nov 1, 2023 (2 total)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Aug 16, 2023 in OK
- Enrollment address
- 1900 N 14TH St
Ponca City, OK 74601-2035 - Hospital subgroups
- Acute care
All disclosed owners & managing parties 6
| Name | Role | Since | Share |
|---|---|---|---|
| Donna M Wallace |
Corporate Officer |
Oct 31, 2023 | |
| Michael L Weed |
Contracted Managing Employee |
Aug 16, 2023 | |
| Corporate Officer |
Oct 31, 2023 | ||
| Operational/Managerial Control |
Aug 16, 2023 | ||
| Integris Health Inc |
Operational/Managerial Control | Aug 16, 2023 | |
| Brent Hubbard |
Contracted Managing Employee |
Aug 16, 2023 | |
| Corporate Officer |
Oct 31, 2023 | ||
| Operational/Managerial Control |
Aug 16, 2023 | ||
| Timothy Pehrson |
Contracted Managing Employee |
Aug 16, 2023 | |
| Corporate Officer |
Oct 31, 2023 | ||
| Corporate Director |
Aug 16, 2023 | ||
| Operational/Managerial Control |
Aug 16, 2023 | ||
| Other |
Nov 1, 2023 | ||
| Christopher Mendoza |
Contracted Managing Employee |
Nov 1, 2023 | |
| Corporate Officer |
Nov 1, 2023 | ||
| Operational/Managerial Control |
Nov 1, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240105000583 | OK | Part a Provider - Hospital | 1052762820 | Practice locations: Ponca City, OK |
National Provider Directory
- Tax ID family
- Integris Health Ponca City Hospital Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | Yes |
Addresses
Primary practice location
1900 N 14TH St
Ponca City, OK 74601-2035
Mailing address
3001 Quail Springs Pkwy FL 3
Oklahoma City, OK 73134-2640
Phone (405) 252-8400
Other names
- INTEGRIS HEALTH PONCA CITY HOSPITAL
Other providers in Ponca City, OK
- Carrie Elizabeth Ingram
- Taylor Ingram
- Integrative Family Care LLC
- Integris Health Ponca City Hospital Inc
- Integris Health Ponca City Hospital Inc
- Internal Medicine Associates of Ponca City PLLC
- Jane Ann Ireland
- Corie L Jackson
- Jessica Lynn Jackson
- Jacob K Jakielaszek
All providers in Ponca City, OK · General Acute Care Hospital in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 21, 2023. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.