NPIMap

Organization Active NPI

Rural Wellness Fairfax Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Fairfax, OK
National Provider Identifier
1982233466
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
RURAL WELLNESS FAIRFAX INC
Practice address
40 Hospital Rd
Fairfax, OK 74637-5084
Phone
(918) 642-3291
NPI assigned
Apr 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Authorized official

Name
Dr. Elizabeth J Pusey
Title
President
Phone
(949) 322-4337

Specialties & licenses 1

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

Addresses

Primary practice location

40 Hospital Rd
Fairfax, OK 74637-5084

Mailing address

2524 N Broadway
Edmond, OK 73034-4172
Phone (949) 322-4337

Other names 1

  • Rural Wellness Fairfax Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200505000918 OK Part A Provider - Critical Access Hospital 3678904752 Practice locations: Fairfax, OK

Hospital certification: CCN 37Z318

Legal name
RURAL WELLNESS FAIRFAX INC
Doing business as
RURAL WELLNESS FAIRFAX HOSPITAL
Organization structure
CorporationProprietary
Incorporated
Dec 10, 2019 in OK
Enrollment address
40 Hospital Rd
Fairfax, OK 74637-5084
Hospital Swing-Bed Unit

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
Rural Wellness Fairfax 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 9

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

NameRoleSinceShare
Elizabeth J Pusey Individual 5% Or Greater Indirect Ownership InterestPresident Nov 1, 2021 100%
Rural Wellness Healthcare LLC Organization, Edmond, OK LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Mar 20, 2020 100%
Hunter Thoms Individual Contracted Managing EmployeeAd; Oct 1, 2020
James I Graham Individual Operational/Managerial ControlDirector Feb 6, 2023
Charlie Cartwright Individual Operational/Managerial ControlDirector Feb 6, 2023
Debi Barnard Individual Operational/Managerial ControlDirector Feb 6, 2023
Rural Hospital Acquisition LLC Organization, Oklahoma City, OK LLC, Owned by another organization or individual 5% Or Greater Security Interest Feb 6, 2023 100%
FPFX Business Solutions, Inc. Organization, Oklahoma City, OK LLC Operational/Managerial Control Feb 6, 2023
Ned Williams Individual Operational/Managerial ControlDirector Feb 6, 2023

Owners & managing parties with NPI records 1

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

Facilities with the same owner 7

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

Practitioners & affiliated clinicians

Affiliated clinicians 5

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": "1586131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1982233466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2524 N BROADWAY",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730344172",
            "telephone_number": "949-322-4337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 HOSPITAL RD",
            "city": "FAIRFAX",
            "state": "OK",
            "postal_code": "746375084",
            "telephone_number": "918-642-3291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RURAL WELLNESS FAIRFAX INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-06",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "PUSEY",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-322-4337",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rural Wellness Fairfax Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairfax, OK

Sources for this page

Verify at the official NPI Registry.