NPIMap

Organization Active NPI

St John Sapulpa

  • Critical Access Hospital
  • Sapulpa, OK
National Provider Identifier
1861794448
Registry record updated Dec 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
2310 Issued in OK
Legal business name
ST JOHN SAPULPA
Practice address
1004 E Bryan Ave
Sapulpa, OK 74066-4513
Phone
(918) 224-4280
Fax
(918) 227-3927
NPI assigned
Dec 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2010

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

Authorized official

Name
Ms. Anita L Raley, MS, MHA
Title
Director of Operations
Phone
(918) 224-4280

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 2310 OK Primary

Addresses

Primary practice location

1004 E Bryan Ave
Sapulpa, OK 74066-4513

Mailing address

PO Box 1368
1004 N Bryan
Sapulpa, OK 74067-1368
Phone (918) 224-4280

Other identifiers 2

IdentifierTypeStateIssuer
00037003301OtherOKMEDICARE
100699550DMedicaidOK

National Provider Directory

National Provider Directory
Tax ID family
St John Sapulpa Outreac3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291248000000",
    "number": "1861794448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1368",
            "address_2": "1004 N BRYAN",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740671368",
            "telephone_number": "918-224-4280",
            "fax_number": "918-227-3927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 E BRYAN AVE",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740664513",
            "telephone_number": "918-224-4280",
            "fax_number": "918-227-3927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHN SAPULPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-02",
        "last_updated": "2010-12-02",
        "status": "A",
        "authorized_official_last_name": "RALEY",
        "authorized_official_first_name": "ANITA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "918-224-4280",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS, MHA"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "OK",
            "license": "2310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "00037003301",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100699550D",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sapulpa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.