NPIMap

Organization Active NPI

State of Oklahoma

  • Rehabilitation Clinic/Center
  • Norman, OK
National Provider Identifier
1609972058
Registry record updated May 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
License
2239 Issued in OK
Legal business name
STATE OF OKLAHOMA
Practice address
2002 E Robinson St
Norman, OK 73071-7420
Phone
(405) 307-2800
Fax
(405) 307-2801
NPI assigned
Sep 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2014

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

Authorized official

Name
Mrs. Victoria Kuestersteffen
Title
Director and Ceo
Phone
(405) 307-2817

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X 2239 OK Primary

Addresses

Primary practice location

2002 E Robinson St
Norman, OK 73071-7420

Mailing address

2002 E Robinson St
Norman, OK 73071-7420
Phone (405) 307-2800

Other identifiers 2

IdentifierTypeStateIssuer
100708750AMedicaidOK
100700670AMedicaidOK

Other names 1

  • D/B/A J D McCarty Center for Children with Developmental Disabilities Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060511000442 OK Part A Provider - Hospital 4486558962 Practice locations: Norman, OK

Hospital certification: CCN 373300

Legal name
STATE OF OKLAHOMA
Doing business as
THE J.D. MCCARTY CENTER FOR CHILDREN WITH DEVELOPMENTAL DISABILITIES
Certification status
Active
Provider type (POS)
Hospital – Children’s
Participating since
Jan 28, 1985
Last certification
Jun 16, 2023
Beds
36
Ownership / control type
State
Organization structure
OtherNon-profit
Enrollment address
2002 E Robinson St.
State of Oklahoma
Norman, OK 73071-7420
Other Hospital Practice Location
Hospital subgroups
Children’s

Other NPIs with the same Medicare PAC ID 7

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

Care Compare: Hospital

Medicare Care Compare
Listed as
J D McCarty Center for ChildrenCCN 373300
Type
Childrens
Ownership
Government - State
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Sallisaw State Veterans Home140 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Erik R Paulson Individual Corporate OfficerBusiness Manager Aug 23, 2012
Michael Powers Individual Corporate Director Jul 1, 2024
W-2 Managing Employee Jul 1, 2022

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Northwest Center for Behavioral HealthFort Supply, OK, CCN 374001 Hospital 5% Or Greater Direct Ownership Interest (100%) Aug 14, 2013
Jim Taliaferro Community Mental Health CenterLawton, OK, CCN 374008 Hospital Operational/Managerial Control Jan 1, 1974
Griffin Memorial HospitalNorman, OK, CCN 374000 Hospital 5% Or Greater Direct Ownership Interest (100%) Aug 13, 2013
Oklahoma State University Medical CenterTulsa, OK, CCN 370078 Hospital Other (100%) Dec 6, 2013
Tulsa Center for Behavioral HealthTulsa, OK, CCN 374026 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2002

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 102

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 102

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399248000000",
    "number": "1609972058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 E ROBINSON ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730717420",
            "telephone_number": "405-307-2800",
            "fax_number": "405-307-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 E ROBINSON ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730717420",
            "telephone_number": "405-307-2800",
            "fax_number": "405-307-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF OKLAHOMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2014-05-05",
        "status": "A",
        "authorized_official_last_name": "KUESTERSTEFFEN",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "DIRECTOR AND CEO",
        "authorized_official_telephone_number": "405-307-2817",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "OK",
            "license": "2239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100708750A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100700670A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "D/B/A J D McCarty Center for Children with Developmental Disabilities",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.