ST JOHN MEDICAL CENTER INC (NPI# 1144306382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144306382 |
| Entity Type | Organization |
| Organization Name | ST JOHN MEDICAL CENTER INC |
| Practice Address |
1923 S Utica Ave Tulsa OK 74104-6520 |
| Practice Telephone | 9187442345 |
| Mailing Telephone | 9187442345 |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2010-11-10 |
| Authorized Official Name | SR. M. THERESE GOTTSCHALK (PRESIDENT/CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9187442180 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | 2265 | OK | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | CHAMPUS | 74104 0000 | 01 |
| OK | BCBS | 00370114001 | 01 |
| OK | 100699400A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154417368 | St John Medical Center Inc | General Acute Care Hospital | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2006-10-05 |
| 1578656161 | St John Medical Center Inc | Rehabilitation Unit | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2006-10-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ST JOHN MEDICAL CENTER INC | 1923 S Utica Ave, Tulsa, OK 74104-6520 |
| Street Address |
1923 S UTICA AVE |
| City | TULSA |
| State | OK |
| Zip Code | 74104-6520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174527667 | Mark Douglas Mills | Pharmacist | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2005-06-13 |
| 1043848880 | Saba Imani | Student in an Organized Health Care Education/Training Program | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2020-03-28 |
| 1073146312 | Tammy Irene Joplin | Clinical Nurse Specialist | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2020-02-14 |
| 1962047563 | Houston Reed Slemp | Nurse Practitioner | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-11-07 |
| 1558903369 | Nicole Coburn | Physician Assistant | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-10-14 |
| 1124669643 | Jordan Beasley | Physician Assistant | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-10-06 |
| 1558926683 | Jacob Blasdel | Student in an Organized Health Care Education/Training Program | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-05-03 |
| 1487217634 | Candice R Rogers | Student in an Organized Health Care Education/Training Program | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-04-15 |
| 1881158178 | Ellen Chadick | Anesthesiologist Assistant | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-01-30 |
| 1528522810 | Hannah Chadick | Anesthesiologist Assistant | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982253811 | Ultimate Health and Pain Management | Pain Medicine | 1844 East 15th Street, Tulsa, OK 74104 | 2019-09-04 |
| 1225691223 | David Murray | Student in an Organized Health Care Education/Training Program | 2100 S Wheeling Ave, Tulsa, OK 74104 | 2019-04-16 |
| 1083115828 | Susan Fortner | Counselor | 1328 S. Delaware Pl, Tulsa, OK 74104 | 2018-02-27 |
| 1033636915 | Mark Brizendine | Dietitian, Registered | Hillcrest Medical Center 1120 S. Utica Ave, Tulsa, OK 74104 | 2017-08-23 |
| 1295259067 | Demi Reyd Cook | Nurse Practitioner | 1717 A South Utica, Tulsa, OK 74104 | 2017-08-02 |
| 1851827059 | Oklahoma Cvs Pharmacy | Durable Medical Equipment & Medical Supplies | 1701 E 15th Street, Tulsa, OK 74104 | 2017-05-08 |
| 1801334982 | Jamie Lynne Miller | Internal Medicine | 2000 S. Wheeling Avenue Ste 510, Tulsa, OK 74104 | 2017-02-08 |
| 1578913430 | Donna Durant-macon | Registered Nurse | 315 South Utica, Tulsa, OK 74104 | 2016-06-21 |
| 1669833851 | Mbc Dental | Dentist | 401 S. Utica Ave, #a, Tulsa, OK 74104 | 2016-03-15 |
| 1518332170 | Neuro Dynamics LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 22 S Lewis, Tulsa, OK 74104 | 2015-12-08 |
| Find all providers in zip 74104 | ||||
| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477813707 | Oklahoma State University Medical Center Trust | Psychiatric Unit | 744 W 9th St, Tulsa, OK 74127-9020 | 2012-05-21 |
| 1205135936 | Parkside, Inc. | Psychiatric Unit | 1220 S Trenton Ave, Tulsa, OK 74120-5421 | 2011-03-21 |
| 1326125311 | Ahs Tulsa Regional Medical Center LLC | Psychiatric Unit | 744 W 9th St, Tulsa, OK 74127-9020 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225583032 | Rick L Owens Jr. | Psychiatric Unit | 115 F St Sw, Ardmore, OK 73401-4705 | 2016-08-22 |
| 1669878880 | Michael Pickens | Psychiatric Unit | 1003 Stone Creek Dr, Ardmore, OK 73401-1462 | 2014-11-16 |
| 1003135260 | Northwest Center for Behavioral Health | Psychiatric Unit | Rr 3 Box 57, Laverne, OK 73848 | 2010-05-26 |
| 1124346754 | Integris Baptist Medical Center Inc | Psychiatric Unit | 2601 N Spencer Rd, Spencer, OK 73084-3649 | 2010-05-06 |
| 1649305723 | Green Country Behavioral Health Services, Inc. | Psychiatric Unit | 2719 E Shawnee Rd, Muskogee, OK 74403-1533 | 2007-02-22 |
| 1457493355 | Green Country Behavioral Health Services, Inc. | Psychiatric Unit | 6365 W Okmulgee St, Muskogee, OK 74401-4595 | 2007-02-14 |
| 1497824742 | Ahs Henryetta Hospital LLC | Psychiatric Unit | Dewey, Bartlett & Main, Henryetta, OK 74437 | 2006-11-08 |
| 1689622615 | Southwestern Medical Center, LLC | Psychiatric Unit | 1602 Sw 82nd St, Lawton, OK 73505-9012 | 2006-05-04 |
| 1417947466 | Uhs of Oklahoma, LLC | Psychiatric Unit | 305 S 5th St, Enid, OK 73701-5832 | 2005-10-21 |
| 1518510296 | Uhs of Oklahoma, LLC | Psychiatric Unit | 305 S 5th St, Enid, OK 73701-5832 | 2019-07-22 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on ST JOHN MEDICAL CENTER INC.
| 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.