NPIMap

Organization Active NPI

Harper County Community Hospital

Doing business as DBA Buffao Family Health Clinic

  • Clinic/Center
  • Buffalo, OK
National Provider Identifier
1801023890
Registry record updated Jun 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
HARPER COUNTY COMMUNITY HOSPITAL
Doing business as
DBA Buffao Family Health Clinic
Practice address
610 N. Hoy
Suite B
Buffalo, OK 73834-0600
Phone
(580) 735-2911
NPI assigned
Jun 17, 2009
Last updated
Jun 17, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2009

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

Authorized official

Name
Shawna S. Herd
Title
Office Manger
Phone
(580) 735-2911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

610 N. Hoy
Suite B
Buffalo, OK 73834-0600

Mailing address

PO Box 600
Buffalo, OK 73834-0600
Phone (580) 735-2911

Other names 1

  • DBA Buffao Family Health 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
O20040216001309 OK Part B Supplier - Clinic/Group Practice 9638081433 Receives reassigned benefits from 10 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Buffalo, OK; Laverne, OK
O20200421001302 OK Part A Provider - Rural Health Clinic 9638081433 Practice locations: Buffalo, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801023890. Details of each certification follow.

Rural health clinic certification: CCN 378539

Legal name
HARPER COUNTY COMMUNITY HOSPITAL
Doing business as
BUFFALO FAMILY HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 30, 2020
Last certification
Jul 30, 2020
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Incorporated
Oct 1, 1966 in OK
Enrollment address
610 N Hoy St
Ste B
Buffalo, OK 73834-8933
Related CCNs
371324

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.

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
37D1102175Buffalo Family Health Clinic610 North Hoy, Suite B, Buffalo, OK 73834Certificate of waiverJul 13, 2027

National Provider Directory

National Provider Directory

Locations

1003 US Highway 64
Buffalo, OK 73834
Phone (580) 735-2555

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Harry Davis Individual Corporate Director Mar 25, 2021
Trent Cronk Individual Corporate DirectorDirector Nov 13, 2023
Brandi Peterman Individual Corporate DirectorDirector Sep 26, 2024
Kevin M Obrien Individual Contracted Managing EmployeeCeo Dec 1, 2019
Corporate OfficerCeo Nov 25, 2019
Juana Lujan Individual W-2 Managing EmployeeBusiness Office Manager Nov 6, 2014
Darla Young Individual Corporate DirectorBoard Member Jun 1, 2018
Terry Shuman Individual Corporate DirectorBoard Member Mar 1, 2015
SSM Health Care of Oklahoma, Inc. Organization, Oklahoma City, OK Non-profit Operational/Managerial Control Oct 1, 2019 100%

Owners & managing parties with NPI records 5

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

Facilities with the same owner 9

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

Practitioners & affiliated clinicians

Practitioners 12

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": "1245196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245196800000",
    "number": "1801023890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 600",
            "city": "BUFFALO",
            "state": "OK",
            "postal_code": "738340600",
            "telephone_number": "580-735-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 N. HOY",
            "address_2": "SUITE B",
            "city": "BUFFALO",
            "state": "OK",
            "postal_code": "738340600",
            "telephone_number": "580-735-2911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARPER COUNTY COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-17",
        "last_updated": "2009-06-17",
        "status": "A",
        "authorized_official_last_name": "HERD",
        "authorized_official_first_name": "SHAWNA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OFFICE MANGER",
        "authorized_official_telephone_number": "580-735-2911"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA Buffao Family Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Buffalo, OK

Sources for this page

Verify at the official NPI Registry.