NPIMap

Organization Active NPI

Interim Healthcare of Oklahoma City, Inc

  • Home Health Agency
  • Oklahoma City, OK
National Provider Identifier
1821057134
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
377658 Issued in OK
Legal business name
INTERIM HEALTHCARE OF OKLAHOMA CITY, INC
Practice address
3613 NW 56TH St Ste 385
Oklahoma City, OK 73112-4531
Phone
(405) 848-3555
Fax
(405) 842-4629
NPI assigned
Mar 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Authorized official

Name
Mr. Joseph S Johnson
Title
Ceo
Phone
(405) 848-3555

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 377658 OK Primary
Community Based Hospice Care Agency 251G00000X 371635 OK

Addresses

Primary practice location

3613 NW 56TH St Ste 385
Oklahoma City, OK 73112-4531

Mailing address

3613 NW 56TH St Ste 385
Oklahoma City, OK 73112-4531
Phone (405) 848-3555

Other identifiers 2

IdentifierTypeStateIssuer
100262720AMedicaidOK
100262720DMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20120307000136 OK Part A Provider - Home Health Agency 5991614992 Practice locations: Oklahoma City, OK
O20160414001277 OK Part A Provider - Hospice 5991614992 Practice locations: Oklahoma City, OK
O20190227003010 OK Part B Supplier - Clinic/Group Practice 5991614992 Receives reassigned benefits from 2 practitioners
Practice locations: Oklahoma City, OK

Home health agency certification: CCN 377658

Legal name
INTERIM HEALTHCARE OF OKLAHOMA CITY, INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 15, 2003
Last certification
Jan 7, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jul 13, 1999 in OK
Enrollment address
3613 NW 56TH St
Ste 385
Oklahoma City, OK 73112-4526

Hospice certification: CCN 371635

Legal name
INTERIM HEALTHCARE OF OKLAHOMA CITY, INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 19, 2004
Last certification
Apr 5, 2022
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Enrollment address
3613 NW 56TH St
Ste 385
Oklahoma City, OK 73112-4531

Care Compare: Home health agency

Medicare Care Compare
Listed as
Interim Healthcare of Oklahoma City, IncCCN 377658
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
May 15, 2003
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Care Compare: Hospice

Medicare Care Compare
Listed as
Interim Healthcare HospiceCCN 371635
Ownership
For-Profit
Certified
May 19, 2004
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

3613 NW 56th St
Ste 385
Oklahoma City, OK 73112
Phone (405) 848-3555

3613 NW 56th St
Oklahoma City, OK 73112
Phone (405) 848-3555

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Sharon Kay Collins Individual 5% Or Greater Direct Ownership InterestChief Operating Officer Jan 1, 2014 25%
Corporate DirectorChief Operating Officer Nov 1, 2003
W-2 Managing EmployeeAd; Nov 1, 2003
Operational/Managerial ControlChief Operating Officer Feb 16, 2015
Corporate DirectorGeneral Manager Nov 1, 2003 10%
Joseph Stephan Johnson Individual 5% Or Greater Direct Ownership Interest Sep 25, 1999 75%
5% Or Greater Direct Ownership Interest Sep 25, 1999
Corporate Director Apr 12, 2003
W-2 Managing Employee Sep 25, 1999

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 8

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

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682640000000",
    "number": "1821057134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3613 NW 56TH ST STE 385",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124531",
            "telephone_number": "405-848-3555",
            "fax_number": "405-842-4629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3613 NW 56TH ST STE 385",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124531",
            "telephone_number": "405-848-3555",
            "fax_number": "405-842-4629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERIM HEALTHCARE OF OKLAHOMA CITY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "405-848-3555",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OK",
            "license": "377658",
            "primary": true
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "OK",
            "license": "371635",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100262720A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100262720D",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.