ST JOHN MEDICAL CENTER INC (NPI# 1154417368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154417368 |
| 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 | 2006-10-05 |
| Last Update Date | 2020-01-29 |
| Authorized Official Name | BENJAMIN SCOTT (PRESIDENT/CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9187442749 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 2265 | OK | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | CHAMPUS | 74104 0000 | 01 |
| OK | 100699400A | 05 | |
| OK | BCBS OF OK | 000370114001 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144306382 | St John Medical Center Inc | Psychiatric Unit | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2006-10-31 |
| 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 | 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 |
|---|---|---|---|---|
| 1386101202 | Tulsa Er & Hospital LLC | General Acute Care Hospital | 717 W. 71st Street, Tulsa, OK 74132-7413 | 2019-02-27 |
| 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 |
| 1093160186 | Precision Surgical Assistants | General Acute Care Hospital | 7509 W 34th Pl, Tulsa, OK 74107-4507 | 2016-04-26 |
| 1194971598 | Saint Francis Hospital Inc | General Acute Care Hospital | 6605 S Yale Ave, Tulsa, OK 74136-3326 | 2008-08-18 |
| 1154598605 | Oklahoma State University Medical Center | General Acute Care Hospital | 744 W 9th St # H410, Tulsa, OK 74127-9020 | 2008-05-14 |
| 1427154178 | Select Specialty Hospital - Tulsa Midtown LLC | General Acute Care Hospital | 1125 S Trenton Ave, 2nd and 3rd Floor, Tulsa, OK 74120-5418 | 2006-09-16 |
| 1487651857 | Oklahoma Surgical Hospital, LLC | General Acute Care Hospital | 2408 E 81st St, Ste 900, Tulsa, OK 74137-4217 | 2005-06-30 |
| 1366857047 | University of Oklahoma School of Community Medicine | General Acute Care Hospital | 1111 S Saint Louis Ave, Tulsa, OK 74120-5440 | 2014-06-22 |
| Find all providers in TULSA | ||||
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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.