Active NPI
Mercy Hospital Healdton, Inc
- Critical Access Hospital
- Healdton, OK
National Provider Identifier
1568615656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Access Hospital
- License
- 2346
- Legal business name
- MERCY HOSPITAL HEALDTON, INC
- Practice address
- 3462 Hospital Rd
Healdton, OK 73438-6124 - Phone
- (580) 229-0701
- NPI assigned
- Nov 3, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Tracy P Enloe
- Title
- Cfo
- Phone
- (405) 752-3161
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | 2346 | OK | Primary |
Addresses
Primary practice location
3462 Hospital Rd
Healdton, OK 73438-6124
Mailing address
4300 W Memorial Rd
Oklahoma City, OK 73120-8304
Phone (405) 752-3724
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090205000358 | OK | Part B Supplier - Clinic/Group Practice | 3375610447 |
Receives reassigned benefits from 57 practitioners 1 other NPI on this enrollment Practice locations: Healdton, OK |
Other NPIs with the same Medicare PAC ID 3
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Medicare Defined Swing Bed Hospital Unit
- Healdton, OK
- NPI 1376790147
3375610447
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Rural Health Clinic/Center
- Healdton, OK
- NPI 1437467388
O20090205000358
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 57
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225670400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1539302400000",
"number": "1568615656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4300 W MEMORIAL RD",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731208304",
"telephone_number": "405-752-3724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3462 HOSPITAL RD",
"city": "HEALDTON",
"state": "OK",
"postal_code": "734386124",
"telephone_number": "580-229-0701"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MERCY HOSPITAL HEALDTON, INC",
"organizational_subpart": "NO",
"enumeration_date": "2008-11-03",
"last_updated": "2018-10-12",
"status": "A",
"authorized_official_last_name": "ENLOE",
"authorized_official_first_name": "TRACY",
"authorized_official_middle_name": "P",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "405-752-3161",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "282NC0060X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital, Critical Access",
"state": "OK",
"license": "2346",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Healdton, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2018; 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.