Ahs Oklahoma Physician Group, LLC
Organization Active NPI Rural Health Clinic/Center · Cushing, OK
NPI 1922683051 · NPPES record last updated Jun 22, 2026
Key facts
- NPI
- 1922683051
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- AHS OKLAHOMA PHYSICIAN GROUP, LLC
- Practice address
- 1025 E 2ND St
Cushing, OK 74023-4136 - Phone
- (918) 225-3627
- NPI assigned
- Mar 10, 2021
- Organization subpart
- No
Authorized official
- Name
- Stephen C. Petrovich
- Title
- Evp General Counsel
- Phone
- (615) 296-3594
Other NPIs with the same Medicare PAC ID 1
Member organizations 1
Facilities with the same owner 61
Practitioners 378
-
Andrea Michele Adams, D.O.
-
Raad Al Awamleh, MD
-
Starla M Allen, D.O.
-
Blake L Anderson, MD PHD
-
Kelli Ann Anderson, APRN, CNP
-
Sarah Andrews, D.O.
-
Veronica Avila, M.D.
-
Andrew Lott Barker, M.D.
-
Clint Justin Basener, D.O
-
Brandi Baxter, CNP
-
Karin Annette Beals, APRN
-
Ajay R Bedekar, M.D.
-
Brooke Belf Kohler, M.A.
-
Marissa L Bernabe, APRN
-
Tara Dawn Boland, NP
-
Shantel Laniece Bolton, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Rural health clinic certification: CCN 373884
- Legal name
- AHS OKLAHOMA PHYSICIAN GROUP LLC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jul 22, 2021
- Last certification
- May 9, 2024
- Ownership / control type
- 1B
- Organization structure
- LLC · Proprietary
- Incorporated
- Apr 20, 2004 in DE
- Enrollment address
- 1025 E 2ND St
Cushing, OK 74023-4136
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Ardent Health Inc |
5% Or Greater Indirect Ownership Interest | Mar 11, 2021 | 100% |
| Kevin Gross |
Corporate Officer |
Mar 11, 2021 | 100% |
| W-2 Managing Employee |
Mar 11, 2021 | 100% | |
| Brian Walton |
Corporate Officer |
Mar 11, 2021 | |
| Ahs Oklahoma, LLC |
5% Or Greater Indirect Ownership Interest | Mar 11, 2021 | 100% |
| Martin Bonick |
Corporate Officer |
Mar 11, 2021 | |
| Ahs Hillcrest Healthcare System LLC |
5% Or Greater Direct Ownership Interest | Mar 11, 2021 | 100% |
| Mary a Crabtree |
Corporate Officer |
Mar 11, 2021 | |
| Ahs Management Company Inc. |
Operational/Managerial Control | Mar 11, 2021 | 100% |
| Stephen C Petrovich |
Corporate Officer |
Mar 11, 2021 | |
| Ardent Legacy Holdings LLC |
5% Or Greater Indirect Ownership Interest | Mar 11, 2021 | 100% |
| Clint Bradley Adams |
Corporate Officer |
Mar 1, 2021 | |
| Ahp Health Partners, Inc |
5% Or Greater Indirect Ownership Interest | May 1, 2021 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210401000956 | OK | Part a Provider - Rural Health Clinic | 9436122496 | Practice locations: Cushing, OK |
National Provider Directory
Locations (25 of 46)
2776 S State Rd
Ionia, MI 48846
Phone (616) 267-8700
12620 S Memorial Dr
Bixby, OK 74008
Phone (918) 574-0150
700 W 7th Ave
Ste 103
Bristow, OK 74010
Phone (918) 367-5531
700 W 7th Ave
Ste 104
Bristow, OK 74010
Phone (918) 367-8818
700 W 7th Ave
Ste 101
Bristow, OK 74010
Phone (918) 367-3272
1551 N 9th St
Broken Arrow, OK 74012
Phone (918) 355-7900
2617 S Elm Pl
Broken Arrow, OK 74012
Phone (918) 455-4541
1116 Manvel Ave
Chandler, OK 74834
Phone (405) 258-5252
1501 N Florence Ave
Ste 350
Claremore, OK 74017
Phone (918) 301-3170
201 W Blue Starr Dr
Ste 300
Claremore, OK 74017
Phone (918) 341-4825
1501 N Florence Ave
Ste 300
Claremore, OK 74017
Phone (918) 341-5200
1220 N Florence Ave
Ste B
Claremore, OK 74017
Phone (918) 582-6544
1390 W Cherokee St
Cleveland, OK 74020
Phone (918) 358-2300
1205 W Main St
Collinsville, OK 74021
Phone (918) 371-2547
1023 E Cherry St
Ste E
Cushing, OK 74023
Phone (918) 225-0550
1023 E Cherry St
Ste C
Cushing, OK 74023
Phone (918) 225-0771
701 E Main St
Jenks, OK 74037
Phone (918) 298-2264
10512 N 110th East Ave
Ste 130
Owasso, OK 74055
Phone (918) 376-8149
10512 N 110th East Ave
Ste 200
Owasso, OK 74055
Phone (918) 376-8450
10215 N 110TH E Ave
Ste 200
Owasso, OK 74055
Phone (918) 376-8840
10512 N 110th East Ave
Ste 300
Owasso, OK 74055
Phone (918) 272-1172
10512 N 110th East Ave
Ste 240
Owasso, OK 74055
Phone (918) 376-8450
1301 NE 1st St
Ste 100
Pryor, OK 74361
Phone (918) 392-0175
109 N Fairland St
Ste 108
Pryor, OK 74361
Phone (918) 825-2070
133 N Fairland St
Ste 1
Pryor, OK 74361
Phone (918) 825-1957
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
1025 E 2ND St
Cushing, OK 74023-4136
Mailing address
340 Seven Springs Way Ste 100
Brentwood, TN 37027-5697
Phone (615) 296-3594
Other names
- Cushing Medical Specialist
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All providers in Cushing, OK · Rural Health Clinic/Center in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.