Active NPI
Ahs Henryetta Hospital LLC
Doing business as Hillcrest Hospital Henryetta
- General Acute Care Hospital
- Henryetta, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Acute Care Hospital
- License
- 2222
- Legal business name
- AHS HENRYETTA HOSPITAL LLC
- Doing business as
- Hillcrest Hospital Henryetta
- Practice address
- 2401 W Main St
Henryetta, OK 74437-3893 - Phone
- (918) 579-7545
- Fax
- (918) 579-5570
- NPI assigned
- Feb 23, 2006
- Last updated
- Oct 1, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Stephen C. Petrovich
- Title
- SVP
- Phone
- (615) 296-3000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | 2222 | OK | Primary |
Addresses
Primary practice location
2401 W Main St
Henryetta, OK 74437-3893
Mailing address
340 Seven Springs Way Ste 100
Brentwood, TN 37027-5697
Phone (918) 579-7545
Other names 1
- Hillcrest Hospital Henryetta
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040820000595 | OK | Part A Provider - Hospital | 9638143282 | Practice locations: Henryetta, OK |
| O20050219000008 | OK | Part B Supplier - Clinic/Group Practice | 9638143282 |
Receives reassigned benefits from 12 practitioners 3 other NPIs on this enrollment Practice locations: Henryetta, OK |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1720053556. Details of each certification follow.
Hospital certification: CCN 370183
- Legal name
- AHS HENRYETTA HOSPITAL LLC
- Doing business as
- HILLCREST HOSPITAL HENRYETTA
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1997
- Last certification
- Sep 15, 2021
- Beds
- 41
- Ownership / control type
- Private (for profit)
- Most recent change of ownership
- Nov 1, 2004 (2 total)
- Organization structure
- LLC
- Incorporated
- Apr 20, 2004 in DE
- Enrollment address
- 2401 W Main St
Henryetta, OK 74437-3893 - Hospital subgroups
- General
Related certifications (CCN) 3
Facilities connected through Provider of Services related, parent or unit certification numbers.
-
dba Utica Park Clinic Primary Care
- Rural Health Clinic/Center
- Henryetta, OK
- NPI 1295232478
Parent provider
-
- Medicare Defined Swing Bed Hospital Unit
- Henryetta, OK
- NPI 1588733828
-
dba Utica Park Clinic Family Care
- Rural Health Clinic/Center
- Henryetta, OK
- NPI 1871008722
Parent provider
Other NPIs with the same Medicare PAC ID 3
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Utica Park Clinic Primary Care
- Rural Health Clinic/Center
- Henryetta, OK
- NPI 1295232478
9638143282
-
- Medicare Defined Swing Bed Hospital Unit
- Henryetta, OK
- NPI 1588733828
9638143282
-
dba Utica Park Clinic Family Care
- Rural Health Clinic/Center
- Henryetta, OK
- NPI 1871008722
9638143282
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Utica Park Clinic Primary Care
- Rural Health Clinic/Center
- Henryetta, OK
- NPI 1295232478
O20050219000008
-
dba Utica Park Clinic Family Care
- Rural Health Clinic/Center
- Henryetta, OK
- NPI 1871008722
O20050219000008
Care Compare: Hospital
Medicare Care Compare- Listed as
- Hillcrest Hospital Henryetta
- Type
- Acute Care Hospitals
- Ownership
- Proprietary
- Medicare certification status
- Active
- Emergency services
- Yes
National Provider Directory
National Provider Directory- Tax ID family
- Ahs Henryetta Hospital LLC
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Utica Park Clinic Primary Care
- Rural Health Clinic/Center
- Henryetta, OK
- NPI 1295232478
-
- Medicare Defined Swing Bed Hospital Unit
- Henryetta, OK
- NPI 1588733828
-
dba Utica Park Clinic Family Care
- Rural Health Clinic/Center
- Henryetta, OK
- NPI 1871008722
Locations
Dept 2223
Tulsa, OK 74182
Ownership & related parties
All disclosed owners & managing parties 15
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Ardent Health Inc | 5% Or Greater Indirect Ownership Interest | Aug 4, 2015 | 100% |
| Kevin Gross | Corporate Officer | Mar 1, 2014 | |
| W-2 Managing Employee | Sep 1, 2021 | 100% | |
| Brian Walton | Corporate Officer | Jan 1, 2019 | |
| Carolyn Schneider | Corporate Officer | Aug 1, 2021 | |
| Ahs Oklahoma, LLC | 5% Or Greater Indirect Ownership Interest | Jan 1, 2019 | 100% |
| Martin Bonick | Corporate Officer | Aug 19, 2020 | |
| Terika Richardson Mbanu | Corporate Officer | Sep 1, 2021 | |
| James Grimes | Corporate Officer | Sep 1, 2021 | |
| Ahs Hillcrest Healthcare System LLC | 5% Or Greater Direct Ownership Interest | Feb 6, 2009 | |
| Mary a Crabtree | Corporate Officer | Aug 20, 2004 | |
| Alfred Lumsdaine | Corporate Officer | Sep 1, 2021 | |
| Ahs Management Company Inc. | Operational/Managerial Control | Jan 1, 2019 | 100% |
| Stephen C Petrovich | Corporate Officer | Aug 20, 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% |
Facilities with the same owner 61
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Rural Health Clinic/Center
- Claremore, OK
- NPI 1356974687
Ahp Health Partners, Inc, Ahs Hillcrest Healthcare System LLC, Ahs Management Company Inc., Ahs Oklahoma, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC
-
- Rural Health Clinic/Center
- Claremore, OK
- NPI 1316579642
Ahp Health Partners, Inc, Ahs Hillcrest Healthcare System LLC, Ahs Management Company Inc., Ahs Oklahoma, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC
-
dba Hillcrest Hospital Claremore
- General Acute Care Hospital
- Claremore, OK
- NPI 1023398807
Ahp Health Partners, Inc, Ahs Hillcrest Healthcare System LLC, Ahs Management Company Inc., Ahs Oklahoma, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC
-
dba Hillcrest Hospital Cushing
- Medicare Defined Swing Bed Hospital Unit
- Cushing, OK
- NPI 1467523894
Ahp Health Partners, Inc, Ahs Hillcrest Healthcare System LLC, Ahs Management Company Inc., Ahs Oklahoma, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC
-
dba Cushing Regional Hospital
- General Acute Care Hospital
- Cushing, OK
- NPI 1801867643
Ahp Health Partners, Inc, Ahs Hillcrest Healthcare System LLC, Ahs Management Company Inc., Ahs Oklahoma, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC
-
dba Utica Park Clinic Primary Care
- Rural Health Clinic/Center
- Henryetta, OK
- NPI 1295232478
Ahp Health Partners, Inc, Ahs Hillcrest Healthcare System LLC, Ahs Oklahoma, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC
-
- Medicare Defined Swing Bed Hospital Unit
- Henryetta, OK
- NPI 1588733828
Ahp Health Partners, Inc, Ahs Hillcrest Healthcare System LLC, Ahs Management Company Inc., Ahs Oklahoma, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC
-
dba Utica Park Clinic Family Care
- Rural Health Clinic/Center
- Henryetta, OK
- NPI 1871008722
Ahp Health Partners, Inc, Ahs Hillcrest Healthcare System LLC, Ahs Management Company Inc., Ahs Oklahoma, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC
-
dba Hillcrest Medical Center
- Rehabilitation Hospital Unit
- Tulsa, OK
- NPI 1679652192
Ahp Health Partners, Inc, Ahs Hillcrest Healthcare System LLC, Ahs Management Company Inc., Ahs Oklahoma, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC
-
dba Hillcrest Medical Center
- General Acute Care Hospital
- Tulsa, OK
- NPI 1629057229
Ahp Health Partners, Inc, Ahs Hillcrest Healthcare System LLC, Ahs Management Company Inc., Ahs Oklahoma, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC
-
dba Cushing Medical Specialist
- Rural Health Clinic/Center
- Cushing, OK
- NPI 1922683051
Ahp Health Partners, Inc, Ahs Hillcrest Healthcare System LLC, Ahs Management Company Inc., Ahs Oklahoma, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC
-
dba Utica Park Clinic Elliott
- Rural Health Clinic/Center
- Pryor, OK
- NPI 1134632037
Ahp Health Partners, Inc, Ahs Hillcrest Healthcare System LLC, Ahs Management Company Inc., Ahs Oklahoma, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC
Practitioners & affiliated clinicians
Practitioners 48
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.
-
- Family Nurse Practitioner
- Henryetta, OK
- NPI 1184046336
-
- Family Medicine Physician
- Lawton, OK
- NPI 1699238105
-
- Nurse Practitioner
- Henryetta, OK
- NPI 1518674563
-
- Family Nurse Practitioner
- Henryetta, OK
- NPI 1013682053
-
- Internal Medicine Physician
- Henryetta, OK
- NPI 1770003063
-
- Surgery Physician
- Tulsa, OK
- NPI 1306801675
-
- Internal Medicine Physician
- Tulsa, OK
- NPI 1740215680
-
- Certified Registered Nurse Anesthetist
- Henryetta, OK
- NPI 1467519496
-
- Surgery Physician
- Tulsa, OK
- NPI 1700834918
-
- Internal Medicine Physician
- Okemah, OK
- NPI 1235628918
-
- Family Medicine Physician
- Tulsa, OK
- NPI 1265921449
-
- Nurse Practitioner
- Jenks, OK
- NPI 1346992740
Affiliated clinicians 135
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140652800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1790812800000",
"number": "1720053556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 SEVEN SPRINGS WAY STE 100",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370275697",
"telephone_number": "918-579-7545",
"fax_number": "918-579-5570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 W MAIN ST",
"city": "HENRYETTA",
"state": "OK",
"postal_code": "744373893",
"telephone_number": "918-579-7545",
"fax_number": "918-579-5570"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AHS HENRYETTA HOSPITAL LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-23",
"last_updated": "2026-10-01",
"certification_date": "2026-10-01",
"status": "A",
"authorized_official_last_name": "PETROVICH",
"authorized_official_first_name": "STEPHEN",
"authorized_official_middle_name": "C.",
"authorized_official_title_or_position": "SVP",
"authorized_official_telephone_number": "615-296-3000",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": "OK",
"license": "2222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Hillcrest Hospital Henryetta",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Henryetta, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.