St John Medical Center Inc

Organization Active NPI Rehabilitation Hospital Unit · Tulsa, OK

NPI 1578656161 · NPPES record last updated Nov 10, 2010

Key facts

NPI
1578656161
Entity type
Organization (NPI type 2)
Primary specialty
Rehabilitation Hospital Unit 273Y00000X
License
2265 (OK)
Legal business name
ST JOHN MEDICAL CENTER INC
Practice address
1923 S Utica Ave
Tulsa, OK 74104-6520
Phone
(918) 744-2345
NPI assigned
Oct 2, 2006
Organization subpart
No

Authorized official

Name
Sr. M. Therese Gottschalk
Title
President/Chief Executive Officer
Phone
(918) 744-2180

Other NPIs on the same Medicare enrollment 1

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

Affiliated clinicians 927

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 927

Medicare Care Compare: Hospital

Listed as
Ascension St John Medical Center CCN 370114
Overall star rating
★★★☆☆ 3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OK

Hospital certification: CCN 370114

Legal name
ST JOHN MEDICAL CENTER INC
Doing business as
ASCENSION ST. JOHN MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Sep 29, 2024
Beds
703 (675 certified)
Ownership / control type
Private (not for profit)
Organization structure
Corporation · Non-profit
Incorporated
Oct 10, 1953 in OK
Enrollment address
1923 S Utica Ave
St John Medical Center
Tulsa, OK 74104-6502
Main/Primary Hospital Location
Hospital subgroups
Acute care

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
St John Health Systems Inc
Organization · Tulsa, OK
Non-profit
5% Or Greater Direct Ownership Interest Sep 8, 1982 100%
Stephen Heyman
Individual
Corporate Director
Board Member
Jan 1, 2024 5%
Charles Terrence Dolan
Individual
Operational/Managerial Control
Board Member
Sep 1, 2015 5%
Joseph P Moran
Individual
Operational/Managerial Control
Board Member
Sep 1, 2015 5%
Robert Farris
Individual
Corporate Director
Board Member
Jan 1, 2024 5%
Jason Hall
Individual
Corporate Officer
Chief Operating Officer
Jul 1, 2025 5%
Stephen D Bruns
Individual
Corporate Director
Board Member
Jan 1, 2024 5%
Loretta Hall
Individual
Corporate Director
Board Member
Jan 1, 2024 5%
Bryan Joseph Cavitt
Individual
Corporate Officer
President
Jul 1, 2025 5%
Theodore Siegfried
Individual
Operational/Managerial Control
Board Member
Jul 1, 2017 5%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20090723000826 OK Part a Provider - Hospital 7810887510 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Broken Arrow, OK; Tulsa, OK

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 2265 OK Yes

Addresses

Primary practice location

1923 S Utica Ave
Tulsa, OK 74104-6520

Mailing address

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (918) 744-2345

Other identifiers

IdentifierTypeStateIssuer
000370114001OtherOKBCBS OF OK
74104 0000OtherOKCHAMPUS
100699400AMedicaidOK

Other names

  • Bernsen Rehab Other name

Other providers in Tulsa, OK

All providers in Tulsa, OK · Rehabilitation Hospital Unit in Oklahoma

Sources for this page

Verify at the official NPI Registry.