NPIMap

Organization Active NPI

Integris Miami Hospital

Doing business as INTEGRIS Express Care Miami

  • Rural Health Clinic/Center
  • Miami, OK
National Provider Identifier
1992305627
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
INTEGRIS MIAMI HOSPITAL
Doing business as
INTEGRIS Express Care Miami
Practice address
21 W Central Ave
Miami, OK 74354-6815
Phone
(918) 542-3900
NPI assigned
Oct 30, 2020
Last updated
Apr 12, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
INTEGRIS MIAMI HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Authorized official

Name
Chris Hammes
Title
Senior Vice President & Coo
Phone
(405) 949-3402

Specialties & licenses 1

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

Addresses

Primary practice location

21 W Central Ave
Miami, OK 74354-6815

Mailing address

5400 N Independence Ave Ste 200
Oklahoma City, OK 73112-5300
Phone (405) 713-5515

Other names 1

  • INTEGRIS Express Care Miami Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031120000383 OK Part B Supplier - Clinic/Group Practice 1254235468 Receives reassigned benefits from 16 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Miami, OK
O20210421002965 OK Part A Provider - Rural Health Clinic 1254235468 Practice locations: Miami, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992305627. Details of each certification follow.

Rural health clinic certification: CCN 378551

Legal name
INTEGRIS MIAMI HOSPITAL
Doing business as
INTEGRIS EXPRESS CARE MIAMI
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 15, 2022
Last certification
Apr 2, 2025
Ownership / control type
2B
Organization structure
LLCNon-profit
Enrollment address
21 W Central Ave
Miami, OK 74354-6815
Related CCNs
370004

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

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D1095193Integris Express Care-Integris Express21 W Central Ave, Miami, OK 74354Certificate of waiverFeb 3, 2027

National Provider Directory

National Provider Directory
Part of
Alliance Private Duty

Locations

2229 S Main St
Grove, OK 74344
Phone (918) 540-2577

102 S Main St
Miami, OK 74354
Phone (918) 542-9733

207 E Bj Tunnell Blvd
Miami, OK 74354
Phone (918) 542-4171

21 W Central Ave
Miami, OK 74354
Phone (918) 540-7573

30 B St SW
Miami, OK 74354
Phone (918) 542-2273

Ownership & related parties

All disclosed owners & managing parties 26

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

NameRoleSinceShare
Alice a Hunt Individual Contracted Managing EmployeeDirector of Physician Operations Feb 1, 2015
Operational/Managerial ControlDirector of Physician Operations Feb 1, 2015
James D Rutter Individual Corporate Director Jul 1, 2016
Chris M Hammes Individual Corporate DirectorSenior Vice President & Coo Jul 17, 2014
John Hampton Individual Corporate Director May 1, 2019
Suzanne Knott Individual Corporate Director May 1, 2019
Charles a Neal Individual Corporate Director Jun 30, 2005
Integris Health Inc Organization, Oklahoma City, OK Corporation, Non-profit Operational/Managerial Control Jul 1, 1994
James M Osborn Individual Contracted Managing EmployeeMedical Director Apr 1, 2021
Operational/Managerial ControlMedical Director Apr 1, 2021
Justin Lee Mitchell Individual Contracted Managing EmployeeHospital Cmo Jul 1, 2018
Corporate OfficerHospital Cmo Jul 1, 2018
Corporate DirectorHospital Cmo Jan 1, 2020
Operational/Managerial ControlHospital Cmo Jul 1, 2018
James Perryman Individual Corporate Director Jul 1, 2017
Jonas Rabel Individual Contracted Managing EmployeeChief Hospital Executive May 1, 2017
Corporate OfficerChief Hospital Executive May 1, 2017
Operational/Managerial ControlChief Hospital Executive May 1, 2017
Baptist Healthcare of Oklahoma LLC Organization, Oklahoma City, OK LLC, Non-profit Operational/Managerial Control Jun 7, 1978
Caleb Goldner Individual Corporate Director Jan 1, 2015
Sue H Sly Individual Corporate Officer Jul 1, 2020
Corporate Director Jun 16, 2005
Grant Kernan Individual Corporate Director Jan 1, 2015
David R Frazier Individual Corporate Director Nov 1, 2017
Ashley C Walker Individual Corporate Director Nov 1, 2017
Integris Rural Health Inc Organization, Oklahoma City, OK Corporation, Non-profit Operational/Managerial Control Jul 1, 1994
Fredrick J Neill Individual Corporate Director Jan 1, 2006
Lynn Pagels Individual Corporate Officer Jul 1, 2020
Corporate Director Jan 1, 2007
Christianna Wright Individual Corporate Director Jan 1, 2015
Jeremy Hogan Individual Corporate Officer Jul 1, 2020
Corporate Director Jul 1, 2018
Patrick Jurgensmeyer Individual Corporate Director Jun 28, 2005
Krisha North Individual W-2 Managing EmployeeClinic Manager Apr 1, 2021
Operational/Managerial ControlClinic Manager Apr 1, 2021
Timothy Pehrson Individual Corporate OfficerPresident & Ceo Aug 1, 2018
OtherChain Home Office Administrator Aug 1, 2018
Kyle J Schauf Individual Corporate Director Jan 1, 2016

Owners & managing parties with NPI records 5

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

Facilities with the same owner 31

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

View all 31

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618185600000",
    "number": "1992305627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 N INDEPENDENCE AVE STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125300",
            "telephone_number": "405-713-5515",
            "fax_number": "405-713-5532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 W CENTRAL AVE",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "743546815",
            "telephone_number": "918-542-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRIS MIAMI HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTEGRIS MIAMI HOSPITAL",
        "enumeration_date": "2020-10-30",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A",
        "authorized_official_last_name": "HAMMES",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT & COO",
        "authorized_official_telephone_number": "405-949-3402"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INTEGRIS Express Care Miami",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miami, OK

Sources for this page

Verify at the official NPI Registry.