ALVA HOSPITAL AUTHORITY (NPI# 1144534603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144534603 |
| Entity Type | Organization |
| Organization Name | ALVA HOSPITAL AUTHORITY |
| Other Organization Name | SMC WEST END CLINIC |
| Practice Address |
800 Share Dr Alva OK 73717-3618 |
| Mailing Address |
800 Share Dr Po Box 727 Alva OK 73717-3618 |
| Practice Telephone | 5803272800 |
| Mailing Telephone | 5803272800 |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2020-09-10 |
| Authorized Official Name | KANDICE ALLEN (CEO) |
| Authorized Official Telephone | 5804303309 |
| Is Organization Subpart | Y |
| Parent Organization Name | ALVA HOSPITAL AUTHORITY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 25482 | OK | Behavioral Health & Social Service Providers |
| N | 207R00000X | Internal Medicine | 25482 | OK | Allopathic & Osteopathic Physicians |
| Y | 261QC0050X |
Clinic/Center Specialization: Critical Access Hospital |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200307510A | 05 |
| Other Name | Type Code |
|---|---|
| SMC West End Clinic | Doing Business As Name - Organization |
| SMC-Kinzie Clinic | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447413422 | Alva Hospital Authority | Family Medicine | 410 4th St Ste K, Alva, OK 73717-2363 | 2008-07-09 |
| 1972685816 | Alva Hospital Authority | Skilled Nursing Facility | 730 Share Dr, Alva, OK 73717-3616 | 2006-10-19 |
| 1679684682 | Alva Hospital Authority | Medicare Defined Swing Bed Unit | 800 Share Dr, Alva, OK 73717-3618 | 2006-08-31 |
| Street Address |
800 SHARE DR |
| City | ALVA |
| State | OK |
| Zip Code | 73717-3618 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568475275 | James Robert Colvert Jr. | Internal Medicine | 800 Share Dr, Alva, OK 73717-3618 | 2006-08-14 |
| 1013574789 | Jeremy D Logsdon | Nurse Practitioner | 800 Share Dr, Alva, OK 73717-3618 | 2019-05-28 |
| 1538675624 | Erin Paige Kruckenberg | Family Medicine | 800 Share Dr, Alva, OK 73717 | 2017-12-27 |
| 1801293790 | Darlene Reynolds | Occupational Therapy Assistant | 800 Share Dr, Alva, OK 73717-3618 | 2014-11-20 |
| 1124447305 | Gwyneth Leigh Holderby | Nurse Practitioner | 800 Share Dr, Alva, OK 73717-3618 | 2014-04-15 |
| 1164737458 | Kasey L Swayden | Physician Assistant | 800 Share Dr, Alva, OK 73717-3618 | 2010-08-11 |
| 1669704243 | Share Medical Center | Durable Medical Equipment & Medical Supplies | 800 Share Dr, Alva, OK 73717-3618 | 2010-02-05 |
| 1023130689 | Bryan Nutter | Nurse Practitioner | 800 Share Dr, Alva, OK 73717-3618 | 2007-04-04 |
| 1679684682 | Alva Hospital Authority | Medicare Defined Swing Bed Unit | 800 Share Dr, Alva, OK 73717-3618 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912382441 | Callie Mosburg | Optometrist | 921 Oklahoma Blvd Ste A, Alva, OK 73717 | 2015-07-27 |
| 1912238924 | Molly Mae Thompson | Counselor | 510 5th St., Alva, OK 73717 | 2010-01-15 |
| 1023214939 | Michelle Baird | Counselor | 429 Barnes Street, Alva, OK 73717 | 2007-06-26 |
| 1619171253 | Stacie Nixon | Counselor | 429 Barnes St, Alva, OK 73717 | 2007-06-14 |
| 1235351552 | Northwest Domestic Crisis Services, Inc. | Community/Behavioral Health | 1330 Oklahoma Blvd., Alva, OK 73717 | 2007-05-03 |
| 1093849440 | North Oklahoma County Mental Health Center | Counselor | 429 Barnes, Alva, OK 73717 | 2007-03-16 |
| 1437222734 | State of Oklahoma | Community/Behavioral Health | 604 Choctaw, Northwest Center for Behavioral Health, Alva, OK 73717 | 2006-11-16 |
| 1396835013 | Holder-southern Drug Company Inc | Pharmacy | 513 Barnes Ave, Alva, OK 73717 | 2006-10-13 |
| 1407968621 | Brent Michael Bogdanovecz | Chiropractor | 317 College Ave, Alva, OK 73717 | 2006-09-01 |
| 1225341803 | Michael Duane Elsey | Counselor | 510 5th St., Alva, OK 73717 | 2010-07-23 |
| Find all providers in zip 73717 | ||||
| Taxonomy Code | 261QC0050X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Critical Access Hospital |
| An outpatient entity, facility, or distinct part of a facility within or affiliated with a Critical Access Hospital that provides access to primary care services for individuals in a small rural community and is Medicare certified. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235665449 | Weatherford Hospital Authority | Clinic/Center | 3743 Legacy, Weatherford, OK 73096-9746 | 2017-05-08 |
| 1700332400 | Seiling Municipal Hospital Authority | Clinic/Center | 100 N Main, Putnam, OK 73659 | 2016-09-01 |
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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.