NPIMap

Organization Active NPI

Oklahoma Spine Hospital LLC

Doing business as Oklahoma Spine Hospital

  • General Acute Care Hospital
  • Oklahoma City, OK
National Provider Identifier
1699745893
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
2345 Issued in OK
Legal business name
OKLAHOMA SPINE HOSPITAL LLC
Doing business as
Oklahoma Spine Hospital
SSM Health Oklahoma Spine Hospital
Practice address
14101 Parkway Commons Dr
Oklahoma City, OK 73134-6012
Phone
(405) 749-2700
Fax
(405) 749-2743
NPI assigned
Jan 23, 2006
Last updated
Apr 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Authorized official

Name
Mr. Kevin Lane Blaylock
Title
C.E.O
Phone
(405) 749-2700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 2345 OK Primary

Addresses

Primary practice location

14101 Parkway Commons Dr
Oklahoma City, OK 73134-6012

Mailing address

PO Box 803918
Kansas City, MO 64180-3918
Phone (405) 775-4241

Other names 2

  • Oklahoma Spine Hospital Doing business as
  • SSM Health Oklahoma Spine 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
O20080623000244 OK Part A Provider - Hospital 3971674755 Practice locations: Oklahoma City, OK
O20171024002964 OK Part B Supplier - Clinic/Group Practice 5294001962 Receives reassigned benefits from 3 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Edmond, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699745893. Details of each certification follow.

Hospital certification: CCN 370206

Legal name
OKLAHOMA SPINE HOSPITAL, L.L.C.
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Dec 14, 1999
Last certification
Jan 20, 2023
Beds
25
Ownership / control type
Physician ownership
Organization structure
LLCProprietary
Incorporated
Feb 17, 1998 in OK
Enrollment address
14101 Parkway Commons Dr
Oklahoma City, OK 73134-6012
Other Hospital Practice Location
Hospital subgroups
General

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Oklahoma Spine HospitalCCN 370206 · All quality measures
Type
Acute Care Hospitals
Ownership
Physician
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member of 1

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

Locations

2017 W I 35 Frontage Rd
Ste 130
Edmond, OK 73013
Phone (405) 757-3630

14101 Parkway Commons Dr
Oklahoma City, OK 73134
Phone (405) 749-2700

2403 W Wrangler Blvd
Seminole, OK 74868
Phone (580) 925-3286

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
Fadi F Nasr Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2024 4.16%
Operational/Managerial ControlMedical Director/Member Dec 31, 2024 4.16%
Jacob B Archer Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2024 2.55%
Andrew B Parkinson Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2024 4.16%
Kevin L Blaylock Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2024 0.75%
Corporate OfficerCeo Dec 31, 2024 0.75%
W-2 Managing EmployeeManager Dec 31, 2024 0.75%
Nathan S Overbey Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2024 0.52%
Benjamin T White Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2024 2.4%
Robert E Tibbs Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2024 3.55%
Operational/Managerial ControlManager Dec 31, 2024 3.55%
Medical Facilities Corporation Organization, Franklin, TN Corporation 5% Or Greater Indirect Ownership Interest Jun 21, 2005 63.96%
Medical Facilities America Inc Organization, Franklin, TN Corporation 5% Or Greater Indirect Ownership Interest May 20, 2011 63.96%
Joseph Bridger Cox Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2024 4.16%
Operational/Managerial ControlManager Dec 31, 2024 4.16%
James Odor Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2024 4.16%
Operational/Managerial ControlManager Dec 31, 2024 4.16%
Osh Holdings II, LLC Organization, Oklahoma City, OK LLC 5% Or Greater Indirect Ownership Interest Dec 31, 2024 12.88%
Brandon R Valantine Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2024 0.52%
Robert J Wienecke Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2024 3.85%
Operational/Managerial ControlMember Dec 31, 2024 3.85%
Osh Holdings, LLC Organization, Oklahoma City, OK LLC 5% Or Greater Direct Ownership Interest Jun 21, 2005 36.04%
Medical Facilities America Holdco 2 LLC Organization, Franklin, TN LLC 5% Or Greater Indirect Ownership Interest Jul 23, 2019 63.96%
Christopher B White Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2024 0.58%
Medical Facilities America Holdco 1 LLC Organization, Franklin, TN LLC 5% Or Greater Indirect Ownership Interest Jul 23, 2019 63.96%
Brian E Snell Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2024 4.16%
Operational/Managerial ControlManager Dec 31, 2024 4.16%
Cooper Kye Alan Yates Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2024 0.52%
Medical Facilities USA Holdings Inc Organization, Sioux Falls, SD Corporation 5% Or Greater Direct Ownership Interest May 31, 2011 63.96%
Joann Parsley Individual W-2 Managing EmployeeCoo Sep 20, 2021

Owners & managing parties with NPI records 13

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

View all 13

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 13

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 13

Affiliated clinicians 105

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

View all 105

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777248000000",
    "number": "1699745893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 803918",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641803918",
            "telephone_number": "405-775-4241",
            "fax_number": "405-841-9385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14101 PARKWAY COMMONS DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731346012",
            "telephone_number": "405-749-2700",
            "fax_number": "405-749-2743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKLAHOMA SPINE HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-23",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A",
        "authorized_official_last_name": "BLAYLOCK",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "LANE",
        "authorized_official_title_or_position": "C.E.O",
        "authorized_official_telephone_number": "405-749-2700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "OK",
            "license": "2345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oklahoma Spine Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SSM Health Oklahoma Spine Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.