NPIMap

Organization Active NPI

Rural Wellness Fairfax Inc

Doing business as Rural Wellness Pawnee Clinic

  • Rural Health Clinic/Center
  • Pawnee, OK
National Provider Identifier
1982233656
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
RURAL WELLNESS FAIRFAX INC
Doing business as
Rural Wellness Pawnee Clinic
Practice address
535 6TH St
Pawnee, OK 74058-2542
Phone
(918) 762-3942
Fax
(918) 762-4675
NPI assigned
Apr 5, 2020
Last updated
Oct 21, 2024By the provider in NPPES
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
Elizabeth J PuseyNPI 1366548232
Title
President
Phone
(949) 645-2321

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

535 6TH St
Pawnee, OK 74058-2542

Mailing address

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

Other names 1

  • Rural Wellness Pawnee Clinic Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address RWF.RHC2@rhc2fairfax.medalliesdirect.net

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200505002302 OK Part A Provider - Rural Health Clinic 3678904752 Practice locations: Pawnee, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982233656. Details of each certification follow.

Rural health clinic certification: CCN 373471

Legal name
RURAL WELLNESS FAIRFAX INC
Doing business as
RURAL WELLNESS PAWNEE CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 11, 2013
Last certification
Jan 13, 2025
Ownership / control type
1B
Most recent change of ownership
Mar 20, 2020 (2 total)
Organization structure
CorporationProprietary
Incorporated
Dec 10, 2019 in OK
Enrollment address
535 6TH St
Pawnee, OK 74058-2542
Related CCNs
371318

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.

Locations

535 6th St
Pawnee, OK 74058
Phone (918) 240-4073

Interoperability endpoints

  • Direct secure messaging: crystalmccarty@rhc2fairfax.medalliesdirect.net
  • Direct secure messaging: geneevans@rhc2fairfax.medalliesdirect.net
  • Direct secure messaging: rwf.rhc2@rhc2fairfax.medalliesdirect.net

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 Mar 20, 2020 100%
Rural Wellness Healthcare LLC Organization, Edmond, OK LLC 5% Or Greater Direct Ownership Interest Nov 1, 2021 100%
Hunter Thoms Individual Contracted Managing EmployeeAd; Oct 1, 2020
James I Graham Individual Operational/Managerial ControlDirector Nov 1, 2021 100%
Charlie Cartwright Individual Operational/Managerial ControlAdministrator Nov 1, 2021 100%
Debi Barnard Individual Operational/Managerial ControlDirector Nov 1, 2021 100%
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 Management services company Operational/Managerial Control Feb 6, 2023 100%
Ned Williams Individual Operational/Managerial ControlAdministrator Nov 1, 2021 100%

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.

Change-of-ownership history 1

DateEventCounterparty
Mar 20, 2020 Change of OwnershipThis provider was the buyer The Pawnee ClinicCCN 373471, OK, NPI 1598039620

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1586044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1982233656",
    "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": "535 6TH ST",
            "city": "PAWNEE",
            "state": "OK",
            "postal_code": "740582542",
            "telephone_number": "918-762-3942",
            "fax_number": "918-762-4675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RURAL WELLNESS FAIRFAX INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-05",
        "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": "949-645-2321"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "RWF.RHC2@rhc2fairfax.medalliesdirect.net",
            "affiliation": "N",
            "address_1": "2308 W Highway 66",
            "city": "Stroud",
            "state": "OK",
            "country_code": "US",
            "postal_code": "740796729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Rural Wellness Pawnee Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pawnee, OK

Sources for this page

Verify at the official NPI Registry.