NPIMap

Organization Active NPI

Ahs Pryor Hospital, LLC

Doing business as Hillcrest Hospital Pryor

  • General Acute Care Hospital
  • Pryor, OK
National Provider Identifier
1780125005
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
AHS PRYOR HOSPITAL, LLC
Doing business as
Hillcrest Hospital Pryor
Practice address
111 N Bailey St
Pryor, OK 74361-4201
Phone
(918) 824-1191
NPI assigned
Mar 20, 2017
Last updated
Oct 5, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
ARDENTH HEALTH PARTNERS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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 1

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

Addresses

Primary practice location

111 N Bailey St
Pryor, OK 74361-4201

Mailing address

1 Burton Hills Blvd
Suite 250
Nashville, TN 37215-6293
Phone (615) 296-3000

Other practice location 1

1301 NE 1st St
Pryor, OK 74361-8850
Phone (918) 825-1600

Other names 1

  • Hillcrest Hospital Pryor Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170717001720 OK Part A Provider - Hospital 3072880624 Practice locations: Pryor, OK
O20180706000232 OK Part B Supplier - Clinic/Group Practice 3072880624 Receives reassigned benefits from 12 practitioners
2 other NPIs on this enrollment
Practice locations: Pryor, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780125005. Details of each certification follow.

Hospital certification: CCN 370015

Legal name
AHS PRYOR HOSPITAL, LLC
Doing business as
HILLCREST HOSPITAL PRYOR
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1975
Last certification
Apr 5, 2024
Beds
48
Ownership / control type
Private (for profit)
Most recent change of ownership
May 1, 2017 (2 total)
Organization structure
LLCProprietary
Incorporated
Feb 8, 2017 in DE
Enrollment address
111 N Bailey St
Pryor, OK 74361-4201
Main/Primary Hospital Location
Hospital subgroups
Acute care

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

Other NPIs with the same Medicare PAC ID 2

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
Hillcrest Hospital PryorCCN 370015 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

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
37D0474968Hillcrest Hospital Pryor111 North Bailey Street, Pryor, OK 74361AccreditationFeb 27, 2027

National Provider Directory

National Provider Directory
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.

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Ardent Health Inc Organization, Brentwood, TN LLC 5% Or Greater Indirect Ownership Interest May 1, 2017 100%
Kevin Gross Individual Corporate OfficerPresident Jan 1, 2019
W-2 Managing Employee Dec 1, 2023
Ahs Oklahoma, LLC Organization, Brentwood, TN Corporation 5% Or Greater Indirect Ownership Interest May 1, 2017 100%
Martin Bonick Individual Corporate OfficerCeo-Chain Office Aug 16, 2020
Ahs Hillcrest Healthcare System LLC Organization, Brentwood, TN LLC 5% Or Greater Direct Ownership Interest May 1, 2017 100%
Mary a Crabtree Individual Corporate OfficerSVP Treasurer Jan 1, 2019
Ahs Management Company Inc. Organization, Brentwood, TN Corporation Operational/Managerial Control Jan 1, 2019 100%
Stephen C Petrovich Individual Corporate OfficerEvp General Counsel and Secretar May 1, 2017
Ardent Legacy Holdings LLC Organization, Brentwood, TN Corporation 5% Or Greater Indirect Ownership Interest May 1, 2017 100%
Ahp Health Partners, Inc Organization, Brentwood, TN Corporation 5% Or Greater Indirect Ownership Interest May 1, 2017 100%

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 Management Company Inc., 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 Management Company Inc., 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 Management Company Inc., 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 Management Company Inc., 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 Management Company Inc., 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 Management Company Inc., 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 Management Company Inc., 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 Management Company Inc., 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 Management Company Inc., 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 Management Company Inc., 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 Management Company Inc., Ahs Oklahoma, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC

    CMS ownership
View all 61

Practitioners & affiliated clinicians

Practitioners 57

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 57

Affiliated clinicians 183

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

View all 183

NPI Registry JSON

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601856000000",
    "number": "1780125005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BURTON HILLS BLVD",
            "address_2": "SUITE 250",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156293",
            "telephone_number": "615-296-3000",
            "fax_number": "615-296-6227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N BAILEY ST",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743614201",
            "telephone_number": "918-824-1191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 NE 1st St",
            "address_purpose": "LOCATION",
            "city": "Pryor",
            "state": "OK",
            "postal_code": "743618850",
            "country_code": "US",
            "telephone_number": "918-825-1600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AHS PRYOR HOSPITAL, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARDENTH HEALTH PARTNERS LLC",
        "enumeration_date": "2017-03-20",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "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": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hillcrest Hospital Pryor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hillcrest Hospital Pryor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pryor, OK

Sources for this page

Verify at the official NPI Registry.