OWASSO MEDICAL FACILITY, INC (NPI# 1144231432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144231432 |
| Entity Type | Organization |
| Organization Name | OWASSO MEDICAL FACILITY, INC |
| Other Organization Name | ST. JOHN OWASSO |
| Practice Address |
12451 E 100th St N Owasso OK 74055-4600 |
| Practice Telephone | 9182745100 |
| Practice Fax Number | 9182745999 |
| Mailing Telephone | 9182745100 |
| Mailing Fax Number | 9182745999 |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2012-11-28 |
| Authorized Official Name | MR. DAVID L PHILLIPS (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9182745100 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST. JOHN HEALTH SYSTEM |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | Hospitals |
| Other Name | Type Code |
|---|---|
| St. John Owasso | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | OWASSO MEDICAL FACILITY, INC. | 12451 E 100th St N, Owasso, OK 74055 |
| Street Address |
12451 E 100TH ST N |
| City | OWASSO |
| State | OK |
| Zip Code | 74055-4600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538196399 | Frank A Desandre Jr. | Anesthesiology | 12451 E 100th St N, Owasso, OK 74055-4600 | 2006-06-27 |
| 1609342468 | Amanda Louise Whorton | Nurse Practitioner | 12451 E 100th St N, Owasso, OK 74055-4600 | 2018-10-19 |
| 1104324615 | Elizabeth Flores | Nurse Practitioner | 12451 E 100th St N, Owasso, OK 74055 | 2018-01-30 |
| 1114257508 | Magnum Health Care, Inc. | Emergency Medicine | 12451 E 100th St N, Owasso, OK 74055-4600 | 2010-01-06 |
| 1861699738 | Audrey Melissa Stanton | Emergency Medicine | 12451 E 100th St N, Emergency Dept, Owasso, OK 74055-4600 | 2007-07-02 |
| 1447454541 | Asif Sarfraz | Emergency Medicine | 12451 E 100th St N, St John Owasso Emergency Dept, Owasso, OK 74055-4600 | 2007-06-13 |
| 1497960009 | Owasso Medical Facility LLC | Clinic/Center | 12451 E 100th St N, Owasso, OK 74055-4600 | 2007-05-14 |
| 1437226917 | Owasso Medical Facility LLC | Pharmacy | 12451 E 100th St N, Owasso, OK 74055-4600 | 2006-11-29 |
| 1932219839 | Bryan P. Shelton | Anesthesiology | 12451 E 100th St N, Owasso, OK 74055-4600 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972151587 | Lakecrest Dental-owasso 96th | Dentist | 9551 N. Owasso Expressway, Suite #100, Owasso, OK 74055 | 2019-08-27 |
| 1205328697 | Eddie Duane Gaut | Case Manager/Care Coordinator | 110 W 3rd St., Apt 11, Owasso, OK 74055 | 2018-06-01 |
| 1821586694 | Kaitlyn Konarik | Speech-Language Pathologist | 12899 E 76th St N, Ste. 109, Owasso, OH 74055 | 2018-04-27 |
| 1043733769 | Kelsey Renae Nicklas | Case Manager/Care Coordinator | 9310 N 163rd East Ave, Owasso, OK 74055 | 2017-07-25 |
| 1700259256 | Genscripts Owasso, LLC | Pharmacy | 9538 N Garnett Rd, Suite 102, Owasso, OK 74055 | 2015-11-05 |
| 1770968810 | Premier Anesthesia Management Inc | Clinic/Center | 19236 E Twin Creeks Dr, Owasso, OK 74055 | 2015-07-29 |
| 1598152407 | Justin Lum | Physical Therapist | 12326 E 86th St N, Owasso, OK 74055 | 2015-04-17 |
| 1033507660 | Kimberly Louise Howard | Physical Therapy Assistant | 12899 East 76th St North, Owasso, OK 74055 | 2015-01-06 |
| 1780920629 | Timothy Ryan Thornton | Behavioral Analyst | 11330 N 94 E Ave, Owasso, OK 74055 | 2012-12-21 |
| 1679842785 | Kelli Marie Ellis | Counselor | 19760 E Fox Run Cir, Owasso, OK 74055 | 2011-12-19 |
| Find all providers in zip 74055 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205846037 | Bailey Medical Center, LLC | General Acute Care Hospital | 10502 N 110th East Ave, Owasso, OK 74055-6655 | 2006-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386101202 | Tulsa Er & Hospital LLC | General Acute Care Hospital | 717 W. 71st Street, Tulsa, OK 74132-7413 | 2019-02-27 |
| 1821565961 | Oklahoma Er Hospital, LLC | General Acute Care Hospital | 15103 N Pennsylvania Ave, Edmond, OK 73013-1401 | 2018-10-26 |
| 1942784715 | Iacc/ehi Nw, LLC | General Acute Care Hospital | 4801 S.e. 15th Street, Del City, OK 73115 | 2018-09-18 |
| 1336623198 | Iacc/ehi Nw, LLC | General Acute Care Hospital | 300 South Rockwell Avenue, Oklahoma City, OK 73128 | 2018-09-18 |
| 1194209155 | Iacc/ehi Nw, LLC | General Acute Care Hospital | 9417 N Council Rd, Oklahoma City, OK 73162-6207 | 2018-09-17 |
| 1265971717 | Tulsa Micro Hospital, LLC | General Acute Care Hospital | 717 West 71st Street, Tulsa, OK 74132 | 2017-02-16 |
| 1811448384 | Emily Hutchinson | General Acute Care Hospital | 6708 E 76th St, Tulsa, OK 74133-3422 | 2016-10-20 |
| 1730635301 | Post Acute Medical Rehabilitation Hospital of Tulsa, LLC | General Acute Care Hospital | 10020 E 91st St, Tulsa, OK 74133-5835 | 2016-09-01 |
| 1922551779 | Malissa Calhoon | General Acute Care Hospital | 1004 Se 1st St, Pryor, OK 74361-4801 | 2016-07-28 |
| 1255884003 | Ou Medical Center | General Acute Care Hospital | 940 Ne 13th St Ste 1360, Oklahoma City, OK 73104-5008 | 2016-07-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.