NPIMap

Organization Active NPI

McCurtain Memorial Medical Management, Inc.

  • Rural Acute Care Hospital
  • Idabel, OK
National Provider Identifier
1629020177
Registry record updated Aug 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
License
2202 Issued in OK
Legal business name
MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC.
Practice address
1301 E Lincoln Rd
Idabel, OK 74745-7300
Phone
(580) 208-3100
Fax
(580) 208-3199
NPI assigned
May 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2009

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

Authorized official

Name
Ray B. Whitmore Jr.
Title
Cfo
Phone
(580) 208-3104

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X
Home Health Agency 251E00000X 7071 OK
Emergency Care Clinic/Center 261QE0002X
Medical Specialty Clinic/Center 261QM2500X
Primary Care Clinic/Center 261QP2300X
Radiology Clinic/Center 261QR0200X
Psychiatric Hospital Unit 273R00000X 2202 OK
Medicare Defined Swing Bed Hospital Unit 275N00000X 2202 OK
Rural Acute Care Hospital 282NR1301X 2202 OK Primary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X

Addresses

Primary practice location

1301 E Lincoln Rd
Idabel, OK 74745-7300

Mailing address

1301 E Lincoln Rd
Idabel, OK 74745-7300
Phone (580) 208-3100

Other identifiers 5

IdentifierTypeStateIssuer
100700920HMedicaidOK
100700920AMedicaidOK
100700920BMedicaidOK
9R049OtherBCBS AR
CD0496OtherOKRAILROAD MEDICARE

Other names 1

  • McCurtain Memorial Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040626000315 OK Part B Supplier - Clinic/Group Practice 8022926252 Receives reassigned benefits from 59 practitioners
3 other NPIs on this enrollment
Practice locations: Idabel, OK; Broken Bow, OK

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
McCurtain Memorial HospitalIdabel, OK, CCN 371342 Hospital 5% Or Greater Direct Ownership Interest (100%) May 5, 1975
McCurtain Memorial HospitalIdabel, OK, CCN 37Z342 Hospital 5% Or Greater Direct Ownership Interest (100%) May 5, 1975
McCurtain Memorial Rural Health Clinic IdabelIdabel, OK, CCN 378554 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jul 1, 2019
Jul 1, 2019
McCurtain Memorial Urgent Care ClinicBroken Bow, OK, CCN 378558 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 1, 2019
Jul 1, 2019
McCurtain Memorial Clinic/Valliant HealthcareValliant, OK, CCN 378553 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Apr 1, 2021
Apr 1, 2021

Owned or controlled facilities with NPI records 6

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

Practitioners & affiliated clinicians

Practitioners 60

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

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249516800000",
    "number": "1629020177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 E LINCOLN RD",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747457300",
            "telephone_number": "580-208-3100",
            "fax_number": "580-208-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E LINCOLN RD",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747457300",
            "telephone_number": "580-208-3100",
            "fax_number": "580-208-3199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCURTAIN MEMORIAL MEDICAL MANAGEMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2009-08-06",
        "status": "A",
        "authorized_official_last_name": "WHITMORE",
        "authorized_official_first_name": "RAY",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "580-208-3104",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OK",
            "license": "7071",
            "primary": false
        },
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "OK",
            "license": "2202",
            "primary": false
        },
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "OK",
            "license": "2202",
            "primary": false
        },
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "OK",
            "license": "2202",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100700920H",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100700920A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100700920B",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AR",
            "identifier": "9R049",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CD0496",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McCurtain Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Idabel, OK

Sources for this page

Verify at the official NPI Registry.