NPIMap

Organization Active NPI

Weatherford Hospital Authority

  • Otolaryngology Physician
  • Weatherford, OK
National Provider Identifier
1689062705
Registry record updated Dec 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
23518 Issued in OK
Legal business name
WEATHERFORD HOSPITAL AUTHORITY
Practice address
3739 Legacy
Weatherford, OK 73096-9746
Phone
(580) 772-2268
Fax
(580) 772-2267
NPI assigned
Dec 23, 2014
Last updated
Dec 23, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2014

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

Authorized official

Name
Debra K Howe
Title
Ceo
Phone
(580) 772-5551

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 23518 OK Primary

Addresses

Primary practice location

3739 Legacy
Weatherford, OK 73096-9746

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
10698870EMedicaidOK
10699870CMedicaidOK
00370092001OtherOKBCBS

Other names 1

  • WRH ENT Clinic Other name

Medicare participation

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

Enrollment records 1

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

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Weatherford Hospital Authority2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1419292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419292800000",
    "number": "1689062705",
    "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": "580-774-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3739 LEGACY",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "730969746",
            "telephone_number": "580-772-2268",
            "fax_number": "580-772-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEATHERFORD HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-23",
        "last_updated": "2014-12-23",
        "status": "A",
        "authorized_official_last_name": "HOWE",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "580-772-5551"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OK",
            "license": "23518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10698870E",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10699870C",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00370092001",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WRH ENT Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Weatherford, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.