NPIMap

Organization Active NPI

Holdenville Hospital Authority

  • Medicare Defined Swing Bed Hospital Unit
  • Holdenville, OK
National Provider Identifier
1821417015
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
2195 Issued in OK
Legal business name
HOLDENVILLE HOSPITAL AUTHORITY
Practice address
100 McDougal Dr
Holdenville, OK 74848-2822
Phone
(405) 379-4200
Fax
(405) 379-4287
NPI assigned
Apr 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2019

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

Authorized official

Name
Mr. Stephen Stewart
Title
Ceo
Phone
(405) 379-4200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 2195 OK Primary

Addresses

Primary practice location

100 McDougal Dr
Holdenville, OK 74848-2822

Mailing address

100 McDougal Dr
Holdenville, OK 74848-2822
Phone (405) 379-4200

Other names 1

  • Holdenville General Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140627000792 OK Part A Provider - Critical Access Hospital 6002031424 Practice locations: Holdenville, OK

Hospital certification: CCN 37Z321

Legal name
HOLDENVILLE HOSPITAL AUTHORITY
Doing business as
HOLDENVILLE GENERAL HOSPITAL
Organization structure
OtherNon-profit
Enrollment address
100 McDougal Drive
Holdenville General Hospital
Holdenville, OK 74848-2822
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
James a Peterson Individual Contracted Managing EmployeeCfo Sep 1, 2021
Corporate OfficerCfo Sep 1, 2021
Stephen C Stewart Individual Contracted Managing EmployeeCeo Oct 16, 2018
Corporate OfficerCeo Oct 16, 2018
Shirley D Orr Individual Corporate OfficerCno Jun 1, 2018
W-2 Managing EmployeeCno Jun 1, 2018
Holdenville Hospital Authority Organization, Holdenville, OK 5% Or Greater Direct Ownership Interest Feb 17, 1998 100%
Chrystal D Landers Individual W-2 Managing Employee Dec 15, 2009

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Holdenville General HospitalHoldenville, OK, CCN 371321 Hospital 5% Or Greater Direct Ownership Interest (100%) Feb 17, 1998
Holdenville General Hospital Rural Health ClinicHoldenville, OK, CCN 373994 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 17, 1998
Holdenville General Hospital Wewoka Health ClinicWewoka, OK, CCN 373477 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2015
Holdenville General Hospital Physician Health ClinicHoldenville, OK, CCN 373488 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) May 1, 2016

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575936000000",
    "number": "1821417015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MCDOUGAL DR",
            "city": "HOLDENVILLE",
            "state": "OK",
            "postal_code": "748482822",
            "telephone_number": "405-379-4200",
            "fax_number": "405-379-4287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MCDOUGAL DR",
            "city": "HOLDENVILLE",
            "state": "OK",
            "postal_code": "748482822",
            "telephone_number": "405-379-4200",
            "fax_number": "405-379-4287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLDENVILLE HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-15",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "405-379-4200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "OK",
            "license": "2195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holdenville General Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Holdenville General Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Holdenville, OK

Sources for this page

Verify at the official NPI Registry.