NPIMap

Organization Active NPI

Grady Memorial Hospital

Doing business as Tuttle Family Medical Clinic

  • Rural Health Clinic/Center
  • Tuttle, OK
National Provider Identifier
1750715439
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GRADY MEMORIAL HOSPITAL
Doing business as
Tuttle Family Medical Clinic
Practice address
4805 E Highway 37
Tuttle, OK 73089-8791
Phone
(405) 381-2301
Fax
(405) 381-3592
NPI assigned
Aug 29, 2013
Last updated
Jan 6, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Authorized official

Name
Steve Pautler
Title
Ceo
Phone
(405) 779-2150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

4805 E Highway 37
Tuttle, OK 73089-8791

Mailing address

2220 W Iowa Ave
Chickasha, OK 73018-2738
Phone (405) 779-2180

Other identifiers 1

IdentifierTypeStateIssuer
100700820PMedicaidOK

Other names 1

  • Tuttle Family Medical Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031203000193 OK Part B Supplier - Clinic/Group Practice 0648175778 Receives reassigned benefits from 101 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rush Springs, OK; Tuttle, OK; Chickasha, OK; Anadarko, OK
O20210928002882 OK Part A Provider - Rural Health Clinic 0648175778 Practice locations: Tuttle, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750715439. Details of each certification follow.

Rural health clinic certification: CCN 378546

Legal name
GRADY MEMORIAL HOSPITAL
Doing business as
TUTTLE FAMILY MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 1, 2021
Last certification
Sep 1, 2021
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
4805 E Highway 37
Tuttle, OK 73089-8791
Related CCNs
370054

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

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 4

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2071035Tuttle Family Medical Clinic4805 E Highway 37, Tuttle, OK 73089Certificate of waiverDec 30, 2027

National Provider Directory

National Provider Directory

Locations

2100 W Iowa Ave
#Five
Chickasha, OK 73018
Phone (405) 224-2100

113 S Rush Ave
Rush Springs, OK 73082
Phone (580) 476-2527

6 E Main St
Tuttle, OK 73089
Phone (405) 381-2201

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Grady Memorial Hospital Organization, Chickasha, OK Operational/Managerial Control Sep 1, 2021
James Hardy Individual Corporate Officer Aug 1, 2019
Brenda Miller Individual Corporate Officer Jan 1, 2017
Jackie L McAdoo Individual Corporate Officer Dec 20, 2015
Heather Witt Individual Corporate Officer May 1, 2016
Thomas Wayne Essex Individual Corporate Officer Jun 1, 2019
Vicky Hodges Individual W-2 Managing Employee Oct 1, 2014
Denver Talley Individual Corporate Officer Feb 1, 1997
Gregory Elliott Individual Corporate Officer May 1, 2019
Warren Spellman Individual Corporate Officer May 1, 2013
Gary Langham Individual Corporate Officer Jun 1, 2019

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Five Oaks Family Medical ClinicChickasha, OK, CCN 373478 Rural health clinic Operational/Managerial Control (100%) Jan 1, 2014

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 111

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 111

NPI Registry JSON

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

{
    "created_epoch": "1377734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767657600000",
    "number": "1750715439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 W IOWA AVE",
            "city": "CHICKASHA",
            "state": "OK",
            "postal_code": "730182738",
            "telephone_number": "405-779-2180",
            "fax_number": "405-779-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 E HIGHWAY 37",
            "city": "TUTTLE",
            "state": "OK",
            "postal_code": "730898791",
            "telephone_number": "405-381-2301",
            "fax_number": "405-381-3592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRADY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-29",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A",
        "authorized_official_last_name": "PAUTLER",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "405-779-2150"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100700820P",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tuttle Family Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tuttle Family Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tuttle, OK

Sources for this page

Verify at the official NPI Registry.