NPIMap

Organization Active NPI

Great Salt Plains Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Enid, OK
National Provider Identifier
1740967785
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GREAT SALT PLAINS HEALTH CENTER, INC.
Practice address
5320 W Chestnut Ave
Enid, OK 73703
Phone
(580) 233-2900
NPI assigned
Jun 30, 2023
Last updated
Jul 6, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
GREAT SALT PLAINS HEALTH CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Authorized official

Name
Timothy Starkey
Title
Ceo
Phone
(580) 215-1766

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

5320 W Chestnut Ave
Enid, OK 73703

Mailing address

205 W Maple Ave Ste 1000
Enid, OK 73701-4047
Phone (580) 596-2800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230817001898 OK Part A Provider - Federally Qualified Health Center (FQHC) 9133201171 Practice locations: Enid, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740967785. Details of each certification follow.

Federally qualified health center certification: CCN 371016

Legal name
GREAT SALT PLAINS HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 13, 2023
Last certification
Nov 13, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 1, 2023 in OK
Enrollment address
5320 W Chestnut Ave
Enid, OK 73703-3563

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
Great Salt Plains Health Center Inc9 organizations share this tax ID, including this one
Part of
Great Salt Plains Health Center Inc

Other organizations with this tax ID 8

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

Locations

405 S Oklahoma Ave
Cherokee, OK 73728
Phone 87724284756012

1106 E Broadway Ave
Enid, OK 73701
Phone (580) 886-2200

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.

NameRoleSinceShare
Leslie Collins Individual Corporate DirectorTreasurer Jun 1, 2023
Robert Brown Individual Corporate DirectorBoard Member Jun 1, 2023
Taylor Arndt Individual Corporate DirectorBoard Member Jun 1, 2023
Susie Koontz Individual Corporate DirectorPresident Jun 1, 2023
Rocio Guzman-Lopez Individual Corporate DirectorBoard Member Jun 1, 2023
Dan Schiedel Individual Corporate DirectorBoard Member Jun 1, 2023
Barbara Hudgens Individual Corporate DirectorBoard Member Jun 1, 2023
Timothy Starkey Individual Corporate DirectorDirector Jun 1, 2023
W-2 Managing EmployeeCeo Jun 1, 2023
Gail Ridgeway Individual Corporate DirectorBoard Member Jun 1, 2023
Rudy Grajales Individual Corporate DirectorBoard Member Jun 1, 2023
Terry . Mote Individual Corporate DirectorBoard Member Jun 1, 2023
James Edmison Individual Corporate DirectorVice President Jun 1, 2023
Jorge Guerrero Individual Corporate DirectorBoard Member Jun 1, 2023
Brandi Schieber Individual Corporate DirectorBoard Member Jun 1, 2023
Karen Hawkins Individual Corporate DirectorBoard Member Jun 1, 2023

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": "1688083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688601600000",
    "number": "1740967785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W MAPLE AVE STE 1000",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737014047",
            "telephone_number": "580-596-2800",
            "fax_number": "580-596-2805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 W CHESTNUT AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "73703",
            "telephone_number": "580-233-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT SALT PLAINS HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREAT SALT PLAINS HEALTH CENTER, INC",
        "enumeration_date": "2023-06-30",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A",
        "authorized_official_last_name": "STARKEY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "580-215-1766"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

Verify at the official NPI Registry.