NPIMap

Organization Active NPI

Weatherford Hospital Authority

Doing business as Weatherford Regional Hospital

  • Critical Access Hospital
  • Weatherford, OK
National Provider Identifier
1639175185
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
2219 Issued in OK
Legal business name
WEATHERFORD HOSPITAL AUTHORITY
Doing business as
Weatherford Regional Hospital
Practice address
3701 E Main St
Weatherford, OK 73096-3309
Phone
(580) 772-5551
Fax
(580) 774-4762
NPI assigned
Jun 21, 2005
Last updated
May 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Authorized official

Name
Georganna Buss
Title
Chief Financial Officer
Phone
(580) 774-4762

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 2219 OK Primary

Addresses

Primary practice location

3701 E Main St
Weatherford, OK 73096-3309

Mailing address

3701 E Main St
Weatherford, OK 73096-3309
Phone (580) 772-5551

Other identifiers 2

IdentifierTypeStateIssuer
100699870EMedicaidOK
100699870CMedicaidOK

Other names 1

  • Weatherford Regional Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040413001105 OK Part B Supplier - Clinic/Group Practice 9032021837 Receives reassigned benefits from 16 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Weatherford, OK
O20061104000207 OK Part A Provider - Critical Access Hospital 9032021837 Receives reassigned benefits from 14 practitioners
2 other NPIs on this enrollment
Practice locations: Weatherford, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639175185. Details of each certification follow.

Hospital certification: CCN 371323

Legal name
WEATHERFORD HOSPITAL AUTHORITY
Doing business as
WEATHERFORD REGIONAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 1, 2003
Last certification
Apr 1, 2026
Beds
25
Ownership / control type
Local
Organization structure
OtherNon-profit
Incorporated
Aug 17, 2007 in OK
Enrollment address
3701 E Main St
Weatherford, OK 73096-3309
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 6

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Weatherford Regional Hospital, Inc of WeatherfordCCN 371323 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Brad Berrong Individual Corporate DirectorSecretary/Treasurer Feb 21, 2000
Georganna Buss Individual Contracted Managing EmployeeCfo May 14, 2018
Corporate OfficerChief Financial Officer May 14, 2018
Weatherford Hospital Authority Organization, Weatherford, OK Operational/Managerial Control Jun 4, 2007
Doug Misak Individual Corporate DirectorChairperson Jan 25, 2016

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Weatherford Regional HospitalWeatherford, OK, CCN 37Z323 Hospital Operational/Managerial Control Jun 4, 2007

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 44

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 44

Affiliated clinicians 130

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

View all 130

NPI Registry JSON

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653264000000",
    "number": "1639175185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 E MAIN ST",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "730963309",
            "telephone_number": "580-772-5551",
            "fax_number": "580-774-4762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 E MAIN ST",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "730963309",
            "telephone_number": "580-772-5551",
            "fax_number": "580-774-4762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEATHERFORD HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-21",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A",
        "authorized_official_last_name": "BUSS",
        "authorized_official_first_name": "GEORGANNA",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "580-774-4762"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "OK",
            "license": "2219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100699870E",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100699870C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Weatherford Regional Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Weatherford Regional Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Weatherford, OK

Sources for this page

Verify at the official NPI Registry.