NPIMap

Organization Active NPI

Cleveland Area Hospital Holdings, Inc.

Doing business as Cleveland Area Hospital Swing Bed

  • Medicare Defined Swing Bed Hospital Unit
  • Cleveland, OK
National Provider Identifier
1881831774
Registry record updated Sep 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
2270 Issued in OK
Legal business name
CLEVELAND AREA HOSPITAL HOLDINGS, INC.
Doing business as
Cleveland Area Hospital Swing Bed
Practice address
1401 West Pawnee
Cleveland, OK 74020
Phone
(918) 358-2501
Fax
(918) 358-5526
NPI assigned
Jan 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2020

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

Authorized official

Name
Edred Benton
Title
Ceo
Phone
(918) 358-5647

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 2270 OK Primary

Addresses

Primary practice location

1401 West Pawnee
Cleveland, OK 74020

Mailing address

1401 West Pawnee Strett
Cleveland, OK 74020-3033
Phone (918) 358-2501

Other names 1

  • Cleveland Area Hospital Swing Bed Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address casemanagement@cahs.cernerdirect.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090309000201 OK Part A Provider - Critical Access Hospital 7810053444 Practice locations: Cleveland, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881831774. Details of each certification follow.

Hospital certification: CCN 37Z320

Legal name
CLEVELAND AREA HOSPITAL HOLDINGS INC
Doing business as
CLEVELAND AREA HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Nov 19, 2008 in OK
Enrollment address
1401 W Pawnee St
Cleveland, OK 74020-3033
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Cleveland Area Hospital Holdings Inc3 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.

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Mary Johnson Individual Corporate Director Jan 1, 2016
Rebecca Thornton Individual W-2 Managing Employee Dec 3, 2012
Sabrina Aldridge Individual W-2 Managing Employee Sep 23, 2013
Jason Ray Moss Individual Corporate OfficerChief Financial Officer May 22, 2020
Mary Thornton Individual W-2 Managing Employee Jan 11, 2017
Cleveland Area Hospital Authority Organization, Cleveland, OK 5% Or Greater Direct Ownership Interest Jan 1, 2009 100%
Operational/Managerial Control Jan 1, 2009 100%
Nathan Langford Individual W-2 Managing EmployeeDelegated Official Nov 10, 2014
Janice Taylor Evans Individual Corporate Director Jun 1, 2018
Edred Benton Individual Corporate OfficerCeo Jan 1, 2016
W-2 Managing Employee Jan 1, 2016
Don Speicher Individual Corporate Director Jan 28, 2019
Charlotte M Sellers Individual Corporate Director Feb 26, 2018
Fred Taylor Individual Corporate Director Jan 1, 2016
Amanda Harmon Individual Corporate Director Feb 26, 2018
Mike Vaughn Individual Corporate Director Sep 27, 2021
Nicole Lake Individual W-2 Managing EmployeeDirector of HR Aug 1, 2023

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1231891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601164800000",
    "number": "1881831774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 WEST PAWNEE STRETT",
            "city": "CLEVELAND",
            "state": "OK",
            "postal_code": "740203033",
            "telephone_number": "918-358-2501",
            "fax_number": "918-358-9274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 WEST PAWNEE",
            "city": "CLEVELAND",
            "state": "OK",
            "postal_code": "74020",
            "telephone_number": "918-358-2501",
            "fax_number": "918-358-5526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND AREA HOSPITAL HOLDINGS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-14",
        "last_updated": "2020-09-27",
        "certification_date": "2020-09-27",
        "status": "A",
        "authorized_official_last_name": "BENTON",
        "authorized_official_first_name": "EDRED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "918-358-5647"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "OK",
            "license": "2270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "casemanagement@cahs.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Case Management",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1401 West Pawnee",
            "city": "Cleveland",
            "state": "OK",
            "country_code": "US",
            "postal_code": "74020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Cleveland Area Hospital Swing Bed",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cleveland Area Hospital Swing Bed",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cleveland, OK

Sources for this page

Verify at the official NPI Registry.