Ahs Pryor Hospital, LLC
Organization Active NPI General Acute Care Hospital · Pryor, OK
NPI 1780125005 · NPPES record last updated Oct 5, 2020
Key facts
- NPI
- 1780125005
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Acute Care Hospital 282N00000X
- Legal business name
- AHS PRYOR HOSPITAL, LLC
- Practice address
- 111 N Bailey St
Pryor, OK 74361-4201 - Phone
- (918) 824-1191
- NPI assigned
- Mar 20, 2017
- Organization subpart
- Yes
- Parent organization (as reported)
- ARDENTH HEALTH PARTNERS LLC
Authorized official
- Name
- Stephen C Petrovich
- Title
- Evp
- Phone
- (615) 296-3000
Other NPIs on the same Medicare enrollment 2
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 2
Related certifications (CCN) 2
Facilities with the same owner 61
Practitioners 57
-
Darin Alan Gwartney, D.O.
-
Lynzi Marie Morgan, APRN-CNP
-
Johnie Louis Owens III, D.O.
-
Kaleb Lee Vaughn, DO
-
David Roy Ring, DO
-
Khalid Saad Aly, MD
-
Kristin Lee Browning, D.O.
-
Elizabeth Aurelia Weilert, APRN FNP-C
-
James Harold Beebe, M.D.
-
Blake L Anderson, MD PHD
-
Jerad Ball, D.O.
-
Lora M Collier, M.D.
-
Mitchell J Collier, M.D.
-
Codi Michelle Crabtree, APRN-CNP
-
Francis C Eaton, DO
-
Breece Michael Eberley, M.D.
-
Leslie Ann Eddleman, D.O.
Affiliated clinicians 183
-
Elie Abed, M.D.
-
Sunil Agrawal, MD
-
Steven C Anagnost, M.D.
-
Blake L Anderson, MD PHD
-
Amir Ashiq, MD
-
Jerad Ball, D.O.
-
Adel Barkat, M.D.
-
Kusum Bhandari, MD
-
Tara Dawn Boland, NP
-
Laura K Brett, MD
-
Kimberly Byler, APRN
-
Craig Steven Cameron, M.D.
-
Mary Ann Cameron, MD
-
Brad Carlson, M.D.
-
George J Carstens III, M.D.
-
Clinton D Cator, PA
-
Brian A. Chalkin, DO
-
Lora M Collier, M.D.
-
Mitchell J Collier, M.D.
-
Timothy Condie, MD
Medicare Care Compare: Hospital
- Listed as
- Hillcrest Hospital Pryor
- Overall star rating
- ★★★★☆ 4 of 5
- Type
- Acute Care Hospitals
- Ownership
- Proprietary
- Medicare certification status
- Active
- Emergency services
- Yes
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 37D0474968 | Hillcrest Hospital Pryor | Accreditation | Feb 27, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OK
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
- LLC · Proprietary
- Incorporated
- Feb 8, 2017 in DE
- Enrollment address
- 111 N Bailey St
Pryor, OK 74361-4201 - Hospital subgroups
- Acute care
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| Ardent Health Inc |
5% Or Greater Indirect Ownership Interest | May 1, 2017 | 100% |
| Kevin Gross |
Corporate Officer |
Jan 1, 2019 | |
| W-2 Managing Employee | Dec 1, 2023 | ||
| Ahs Oklahoma, LLC |
5% Or Greater Indirect Ownership Interest | May 1, 2017 | 100% |
| Martin Bonick |
Corporate Officer |
Aug 16, 2020 | |
| Ahs Hillcrest Healthcare System LLC |
5% Or Greater Direct Ownership Interest | May 1, 2017 | 100% |
| Mary a Crabtree |
Corporate Officer |
Jan 1, 2019 | |
| Ahs Management Company Inc. |
Operational/Managerial Control | Jan 1, 2019 | 100% |
| Stephen C Petrovich |
Corporate Officer |
May 1, 2017 | |
| Ardent Legacy Holdings LLC |
5% Or Greater Indirect Ownership Interest | May 1, 2017 | 100% |
| Ahp Health Partners, Inc |
5% Or Greater Indirect Ownership Interest | May 1, 2017 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Ahs Pryor Hospital LLC
Locations
1301 NE 1st St
Pryor, OK 74361
Phone (918) 824-6407
111 N Bailey St
Pryor, OK 74361
Phone (918) 824-7791
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | Yes |
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
- Hillcrest Hospital Pryor
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All providers in Pryor, OK · General Acute Care Hospital in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.