Ahs Hillcrest Medical Center LLC
Organization Active NPI Rehabilitation Hospital Unit · Tulsa, OK
NPI 1679652192 · NPPES record last updated Dec 2, 2011
Key facts
- NPI
- 1679652192
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rehabilitation Hospital Unit 273Y00000X
- License
- 2264 (OK)
- Legal business name
- AHS HILLCREST MEDICAL CENTER LLC
- Practice address
- 1120 S Utica Ave
Tulsa, OK 74104-4012 - Phone
- (918) 579-1000
- Fax
- (918) 579-7599
- NPI assigned
- Nov 3, 2006
- Organization subpart
- No
Authorized official
- Name
- Stephen C. Petrovich
- Title
- SVP
- Phone
- (615) 296-3000
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 2
Member organizations 1
Related certifications (CCN) 1
Facilities with the same owner 61
Practitioners 3
-
Perri Anne Craven, M.D.
-
Aaron Matthew McGuire, D.O.
Affiliated clinicians 3
-
Aaron Matthew McGuire, D.O.
-
Isaiah Wilson, M.D.
Medicare Care Compare: Inpatient rehabilitation facility
- Listed as
- Hillcrest Kaiser Rehabilitation Center
- Ownership
- For profit
- Certified
- Jun 30, 2006
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Hospital certification: CCN 37T001
- Legal name
- AHS HILLCREST MEDICAL CENTER, LLC
- Doing business as
- HILLCREST MEDICAL CENTER
- Organization structure
- LLC · Proprietary
- Incorporated
- Apr 20, 2004 in DE
- Enrollment address
- 1120 S Utica Ave
Tulsa, OK 74104-4012 - Hospital subgroups
- Rehabilitation, Rehabilitation unit
All disclosed owners & managing parties 9
| Name | Role | Since | Share |
|---|---|---|---|
| Ardent Health Inc |
5% Or Greater Indirect Ownership Interest | Aug 4, 2015 | 100% |
| Kevin Gross |
Corporate Director |
Jan 1, 2023 | 100% |
| W-2 Managing Employee |
Jan 1, 2023 | 100% | |
| Ahs Oklahoma, LLC |
5% Or Greater Indirect Ownership Interest | Jan 1, 2019 | 100% |
| Ahs Hillcrest Healthcare System LLC |
5% Or Greater Indirect Ownership Interest | Feb 6, 2009 | |
| Mary a Crabtree |
Corporate Officer | Aug 1, 2004 | |
| Ahs Management Company Inc. |
Operational/Managerial Control | Jan 1, 2019 | 100% |
| Stephen C Petrovich |
Corporate Director | Aug 1, 2004 | |
| Ardent Legacy Holdings LLC |
5% Or Greater Indirect Ownership Interest | Aug 4, 2015 | 100% |
| Ahp Health Partners, Inc |
5% Or Greater Indirect Ownership Interest | Jan 1, 2019 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080613000534 | OK | Part a Provider - Hospital | 7618922972 | Practice locations: Tulsa, OK |
National Provider Directory
- Tax ID family
- Ahs Hillcrest Medical Center LLC
Locations
Dept 1230
Tulsa, OK 74182
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Hospital Unit | 273Y00000X | 2264 | OK | Yes |
Addresses
Primary practice location
1120 S Utica Ave
Tulsa, OK 74104-4012
Mailing address
1120 S Utica Ave
Tulsa, OK 74104-4012
Phone (918) 579-1000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000370001704 | Other | OK | BCBS |
| 200044210B | Medicaid | OK |
Other names
- Hillcrest Medical Center
Other providers in Tulsa, OK
- Noor Ahmed
- Onan Ahmed
- Sana Ahmed
- Yasir Ahmed
- Ahs Hillcrest Medical Center LLC
- Ahs Hillcrest Medical Center LLC
- Ahs Hillcrest Medical Center, LLC
- Ahs Oklahoma Heart LLC
- Ahs Oklahoma Physician Group LLC
- Ahs Oklahoma Physicians Group L.L.C.
All providers in Tulsa, OK · Rehabilitation Hospital Unit in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.