NPIMap

Organization Active NPI

Newman Memorial Hospital, Inc

Doing business as Newman Healthcare Associates

  • Rural Health Clinic/Center
  • Shattuck, OK
National Provider Identifier
1821554734
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
NEWMAN MEMORIAL HOSPITAL, INC
Doing business as
Newman Healthcare Associates
Practice address
905 S Main St
Shattuck, OK 73858-9205
Phone
(580) 938-5534
NPI assigned
Feb 15, 2019
Last updated
Feb 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Authorized official

Name
Tamara Noble
Title
Office Manager
Phone
(580) 938-2551

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X
Critical Access Hospital Clinic/Center 261QC0050X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

905 S Main St
Shattuck, OK 73858-9205

Mailing address

905 S Main St
Shattuck, OK 73858-9205
Phone (580) 938-2551

Other names 1

  • Newman Healthcare Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190820002514 OK Part A Provider - Rural Health Clinic 2567482367 Practice locations: Shattuck, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821554734. Details of each certification follow.

Rural health clinic certification: CCN 378533

Legal name
NEWMAN MEMORIAL HOSPITAL, INC
Doing business as
NEWMAN HEALTHCARE ASSOCIATES
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 16, 2020
Last certification
Mar 21, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Dec 31, 1948 in OK
Enrollment address
905 S Main St
Shattuck, OK 73858-9205
Related CCNs
371336

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).

National Provider Directory

National Provider Directory
Tax ID family
Newman Memorial Hospita7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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
Delyn Pool Individual Corporate Officer Feb 28, 2022
Thomas R Vasko Individual Corporate DirectorCeo Feb 9, 2023
W-2 Managing EmployeeCeo Feb 9, 2023
Angela Prather Individual Corporate OfficerVice President May 1, 2006
Gregory S Huenergardt Individual Corporate OfficerPresident Apr 1, 2001
Danna K Stuart Individual Operational/Managerial ControlMD Jun 11, 2019
John Cully Individual Corporate Director Sep 30, 2016
Barclay Holt Individual Corporate Officer Feb 28, 2022
Brittany C Rash Individual W-2 Managing Employee Jun 11, 2019
Ricky Messer Individual Corporate Officer Feb 28, 2020
Jenilee Hinkle Individual Corporate Director Sep 30, 2016

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Newman Healthcare Associates WoodwardWoodward, OK, CCN 378563 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2025

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 8

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": "1550188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1821554734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 S MAIN ST",
            "city": "SHATTUCK",
            "state": "OK",
            "postal_code": "738589205",
            "telephone_number": "580-938-2551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 S MAIN ST",
            "city": "SHATTUCK",
            "state": "OK",
            "postal_code": "738589205",
            "telephone_number": "580-938-5534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWMAN MEMORIAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-15",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A",
        "authorized_official_last_name": "NOBLE",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "580-938-2551"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Critical Access Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Newman Healthcare Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shattuck, OK

Sources for this page

Verify at the official NPI Registry.