NPIMap

Organization Active NPI

Grady Memorial Hospital

Doing business as Five Oaks Medical Group

  • Clinic/Center
  • Chickasha, OK
National Provider Identifier
1659302115
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
GRADY MEMORIAL HOSPITAL
Doing business as
Five Oaks Medical Group
Practice address
2100 W Iowa Ave
Chickasha, OK 73018-2736
Phone
(405) 224-2100
Fax
(405) 779-2346
NPI assigned
Jul 5, 2006
Last updated
Jan 6, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Authorized official

Name
Steve Pautler
Title
Ceo
Phone
(405) 779-2150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

2100 W Iowa Ave
Chickasha, OK 73018-2736

Mailing address

2100 W Iowa Ave
Chickasha, OK 73018-2736
Phone (405) 224-2100

Other identifiers 1

IdentifierTypeStateIssuer
100700820EMedicaidOK

Other names 1

  • Five Oaks Medical Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031203000193 OK Part B Supplier - Clinic/Group Practice 0648175778 Receives reassigned benefits from 101 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rush Springs, OK; Tuttle, OK; Chickasha, OK; Anadarko, OK

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory

Locations

7204 S Pennsylvania Ave
Oklahoma City, OK 73159
Phone (405) 604-9595

113 S Rush Ave
Rush Springs, OK 73082
Phone (580) 476-2527

Practitioners & affiliated clinicians

Practitioners 60

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 60

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767657600000",
    "number": "1659302115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 W IOWA AVE",
            "city": "CHICKASHA",
            "state": "OK",
            "postal_code": "730182736",
            "telephone_number": "405-224-2100",
            "fax_number": "405-779-2346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 W IOWA AVE",
            "city": "CHICKASHA",
            "state": "OK",
            "postal_code": "730182736",
            "telephone_number": "405-224-2100",
            "fax_number": "405-779-2346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRADY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A",
        "authorized_official_last_name": "PAUTLER",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "405-779-2150"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100700820E",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Five Oaks Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chickasha, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2026; 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.

Verify at the official NPI Registry.