Ahs Pryor Hospital, LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

AHS PRYOR HOSPITAL, LLC

Doing business as

Utica Park Clinic Family Medicine

Practice address

1301 NE 1St St Ste 400
Pryor, OK 74361

Phone

(918) 824-8000

Fax

(918) 825-5505

NPI assigned

Apr 12, 2018

Last updated

Jun 4, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephen C. Petrovich

Title

Evp

Phone

(615) 296-3000

Specialties & licenses 2

Addresses

Other names 1

• Utica Park Clinic Family Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in OK2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740787928. Details of each certification follow.

• CCN 378523 Rural health clinic · Active · Details

Rural health clinic certification: CCN 378523

Legal name

AHS PRYOR HOSPITAL, LLC

Doing business as

UTICA PARK CLINIC FAMILY MEDICINE

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Mar 13, 2019

Last certification

Mar 3, 2025

Ownership / control type

1B

Organization structure

LLCProprietary

Enrollment address

1301 NE 1St St
Ste 400
Pryor, OK 74361-8851

Related CCNs

370015

Related certifications (CCN) 1

Facilities connected through Provider of Services related, parent or unit certification numbers.

• Ahs Pryor Hospital, LLC

  dba Hillcrest Hospital Pryor

  • General Acute Care Hospital
  • Pryor, OK
  • NPI 1780125005

  Parent provider

  Provider of Services

Other NPIs with the same Medicare PAC ID 2

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

• Ahs Pryor Hospital, LLC

  dba Utica Park Clinic Elliott

  • Rural Health Clinic/Center
  • Pryor, OK
  • NPI 1134632037

  3072880624

  Same PAC ID
• Ahs Pryor Hospital, LLC

  dba Hillcrest Hospital Pryor

  • General Acute Care Hospital
  • Pryor, OK
  • NPI 1780125005

  3072880624

  Same PAC ID

Other NPIs on the same Medicare enrollment 2

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

• Ahs Pryor Hospital, LLC

  dba Utica Park Clinic Elliott

  • Rural Health Clinic/Center
  • Pryor, OK
  • NPI 1134632037

  O20180706000232

  Same enrollment
• Ahs Pryor Hospital, LLC

  dba Hillcrest Hospital Pryor

  • General Acute Care Hospital
  • Pryor, OK
  • NPI 1780125005

  O20180706000232

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Ahs Pryor Hospital LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Ahs Pryor Hospital, LLC

  dba Utica Park Clinic Elliott

  • Rural Health Clinic/Center
  • Pryor, OK
  • NPI 1134632037
  NPD tax ID
• Ahs Pryor Hospital, LLC

  dba Hillcrest Hospital Pryor

  • General Acute Care Hospital
  • Pryor, OK
  • NPI 1780125005
  NPD tax ID

All disclosed owners & managing parties 9

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

Facilities with the same owner 61

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

• Ahs Claremore Regional Hospital LLC

  • Rural Health Clinic/Center
  • Claremore, OK
  • NPI 1356974687

  Ahp Health Partners, Inc, Ahs Hillcrest Healthcare System LLC, Ahs Oklahoma, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC

  CMS ownership
• Ahs Claremore Regional Hospital, LLC

  • Rural Health Clinic/Center
  • Claremore, OK
  • NPI 1316579642

  Ahp Health Partners, Inc, Ahs Hillcrest Healthcare System LLC, Ahs Oklahoma, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC

  CMS ownership
• Ahs Claremore Regional Hospital, LLC.

  dba Hillcrest Hospital Claremore

  • General Acute Care Hospital
  • Claremore, OK
  • NPI 1023398807

  Ahp Health Partners, Inc, Ahs Hillcrest Healthcare System LLC, Ahs Oklahoma, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC

  CMS ownership
• Ahs Cushing Hospital 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 Oklahoma, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC

  CMS ownership
• Ahs Cushing Hospital LLC

  dba Cushing Regional Hospital

  • General Acute Care Hospital
  • Cushing, OK
  • NPI 1801867643

  Ahp Health Partners, Inc, Ahs Hillcrest Healthcare System LLC, Ahs Oklahoma, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC

  CMS ownership
• Ahs Henryetta Hospital 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

  CMS ownership
• Ahs Henryetta Hospital LLC

  • Medicare Defined Swing Bed Hospital Unit
  • Henryetta, OK
  • NPI 1588733828

  Ahp Health Partners, Inc, Ahs Hillcrest Healthcare System LLC, Ahs Oklahoma, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC

  CMS ownership
• Ahs Henryetta Hospital LLC

  dba Hillcrest Hospital Henryetta

  • General Acute Care Hospital
  • Henryetta, OK
  • NPI 1720053556

  Ahp Health Partners, Inc, Ahs Hillcrest Healthcare System LLC, Ahs Oklahoma, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC

  CMS ownership
• Ahs Henryetta Hospital 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 Oklahoma, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC

  CMS ownership
• Ahs Hillcrest Medical Center LLC

  dba Hillcrest Medical Center

  • Rehabilitation Hospital Unit
  • Tulsa, OK
  • NPI 1679652192

  Ahp Health Partners, Inc, Ahs Hillcrest Healthcare System LLC, Ahs Oklahoma, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC

  CMS ownership
• Ahs Hillcrest Medical Center, LLC

  dba Hillcrest Medical Center

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1629057229

  Ahp Health Partners, Inc, Ahs Hillcrest Healthcare System LLC, Ahs Oklahoma, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC

  CMS ownership
• Ahs Oklahoma Physician Group, LLC

  dba Cushing Medical Specialist

  • Rural Health Clinic/Center
  • Cushing, OK
  • NPI 1922683051

  Ahp Health Partners, Inc, Ahs Hillcrest Healthcare System LLC, Ahs Oklahoma, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC

  CMS ownership

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559606400000",
    "number": "1740787928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 NE 1ST ST STE 400",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743618851",
            "telephone_number": "918-824-8000",
            "fax_number": "918-825-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 NE 1ST ST STE 400",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "74361",
            "telephone_number": "918-824-8000",
            "fax_number": "918-825-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AHS PRYOR HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-12",
        "last_updated": "2019-06-04",
        "status": "A",
        "authorized_official_last_name": "PETROVICH",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "EVP",
        "authorized_official_telephone_number": "615-296-3000"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Utica Park Clinic Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brandy Adams, MSW
• Wendy Rachell Adams
• Hilary Nicole Admire
• Advanced Dental Solutions PS (Pryor Dental Center)
• Ahs Pryor Hospital, LLC (Utica Park Clinic Elliott)
• Ahs Pryor Hospital, LLC (Hillcrest Hospital Pryor)
• Beth Akerman
• Valerie Albert
• Jamie Konstance Allen
• Alliance Mental Health, LLC.

• Rural Health Clinic/Center in Pryor, OK
• Providers in Pryor, OK by specialty
• Rural Health Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; 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.

Verify at the official NPI Registry.