Active NPI
Integris Miami Hospital
- Ambulance
- Miami, OK
National Provider Identifier
1861534786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulance
- License
- 2193
- Legal business name
- INTEGRIS MIAMI HOSPITAL
- Practice address
- 200 2ND Ave SW
Miami, OK 74354-6830 - Phone
- (918) 542-6611
- NPI assigned
- Feb 14, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Carl Bruce Lawrence
- Title
- President Ceo
- Phone
- (405) 949-6066
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 2193 | OK | Primary |
Addresses
Primary practice location
200 2ND Ave SW
Miami, OK 74354-6830
Mailing address
200 2ND Ave SW
Miami, OK 74354-6830
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100699440B | Medicaid | OK | |
| 800156002 | Medicaid | MO | |
| 100242850B | Medicaid | KS |
Other names 1
- Integris Miami EMS
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080708000640 | OK | Part A Provider - Hospital | 1254235468 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Miami, OK |
Hospital certification: CCN 370004
- Legal name
- INTEGRIS MIAMI HOSPITAL
- Doing business as
- INTEGRIS MIAMI HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Oct 1, 1978
- Last certification
- Dec 21, 2021
- Beds
- 117 (114 certified)
- Ownership / control type
- Other
- Organization structure
- LLC
- Incorporated
- Feb 1, 1994 in OK
- Enrollment address
- 200 2ND Ave SW
Miami, OK 74354-6830 - Hospital subgroups
- General, Acute care
Related certifications (CCN) 2
Facilities connected through Provider of Services related, parent or unit certification numbers.
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Care Compare: Hospital
Medicare Care Compare- Listed as
- Integris Miami Hospital
- Overall star rating
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Other
- Medicare certification status
- Active
- Emergency services
- Yes
National Provider Directory
National Provider Directory- Tax ID family
- Baptist Regional HLTH C
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pharmacy
- Miami, OK
- NPI 1285134825
-
- Early Intervention Provider Agency
- Miami, OK
- NPI 1366824047
-
- Home Health Agency
- Miami, OK
- NPI 1194748319
-
- Community Based Hospice Care Agency
- Miami, OK
- NPI 1457368342
Ownership & related parties
All disclosed owners & managing parties 21
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| James D Rutter | Corporate Director | Jul 1, 2016 | |
| John Hampton | Corporate Director | May 1, 2019 | |
| Suzanne Knott | Corporate Director | May 1, 2019 | |
| Michael L Weed | Corporate Officer | Jun 1, 2020 | |
| W-2 Managing Employee | Jun 1, 2020 | ||
| Casey Ahlden | Corporate Director | Jan 1, 2023 | |
| W-2 Managing Employee | Jan 1, 2023 | ||
| Charles a Neal | Corporate Director | Jan 1, 2008 | |
| Integris Health Inc | 5% Or Greater Direct Ownership Interest | Jan 1, 1995 | 100% |
| Justin Lee Mitchell | Corporate Director | Dec 1, 2019 | |
| James Perryman | Corporate Director | Jul 1, 2017 | |
| Jonas Rabel | Corporate Officer | May 1, 2017 | |
| W-2 Managing Employee | May 1, 2017 | ||
| Baptist Healthcare of Oklahoma LLC | Operational/Managerial Control | Jun 22, 1994 | 100% |
| Caleb Goldner | Corporate Director | Jan 1, 2015 | |
| Sue H Sly | Corporate Director | Jan 1, 1994 | |
| Grant Kernan | Corporate Director | Jan 1, 2015 | |
| David R Frazier | Corporate Director | Nov 1, 2017 | |
| Integris Rural Health Inc | 5% Or Greater Direct Ownership Interest | Feb 14, 1994 | 100% |
| Operational/Managerial Control | Feb 14, 1994 | 100% | |
| Fredrick J Neill | Corporate Director | Jan 1, 2016 | |
| Lynn Pagels | Corporate Director | Jan 1, 2017 | |
| Christianna Wright | Corporate Director | Jan 1, 2015 | |
| Patrick Jurgensmeyer | Corporate Director | Jan 1, 2006 | |
| Kyle J Schauf | Corporate Director | Jan 1, 2016 |
Owners & managing parties with NPI records 3
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
Practitioners & affiliated clinicians
Affiliated clinicians 113
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Sleep Medicine (Internal Medicine) Physician
- Oklahoma City, OK
- NPI 1164654117
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1490313600000",
"number": "1861534786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 2ND AVE SW",
"city": "MIAMI",
"state": "OK",
"postal_code": "743546830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 2ND AVE SW",
"city": "MIAMI",
"state": "OK",
"postal_code": "743546830",
"telephone_number": "918-542-6611"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INTEGRIS MIAMI HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-14",
"last_updated": "2017-03-24",
"status": "A",
"authorized_official_last_name": "LAWRENCE",
"authorized_official_first_name": "CARL",
"authorized_official_middle_name": "BRUCE",
"authorized_official_title_or_position": "PRESIDENT CEO",
"authorized_official_telephone_number": "405-949-6066"
},
"taxonomies": [
{
"code": "341600000X",
"taxonomy_group": "",
"desc": "Ambulance",
"state": "OK",
"license": "2193",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100699440B",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "800156002",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100242850B",
"state": "KS"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Integris Miami EMS",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Miami, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.