JACKSON COUNTY MEMORIAL HOSPITAL AUTHORITY (NPI# 1245614387) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245614387 |
| Entity Type | Organization |
| Organization Name | JACKSON COUNTY MEMORIAL HOSPITAL AUTHORITY |
| Other Organization Name | JCMH MEDICAL CLINIC |
| Practice Address |
205 S Park Ln Altus OK 73521-5755 |
| Mailing Address |
1200 E Pecan St Altus OK 73521-6141 |
| Practice Telephone | 5803796650 |
| Mailing Telephone | 5803795000 |
| Enumeration Date | 2015-07-18 |
| Last Update Date | 2015-11-30 |
| Authorized Official Name | MR. STEVE HARTGRAVES (CEO) |
| Authorized Official Telephone | 5803795500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| JCMH MEDICAL CLINIC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699724757 | Jackson County Memorial Hospital Authority | Home Health | 1204 E Tamarack Rd, Altus, OK 73521-1234 | 2006-05-08 |
| 1962978916 | Jackson County Memorial Hospital Authority | Clinic/Center | 304 S Park Ln Ste B, Altus, OK 73521-5754 | 2018-10-17 |
| 1972987014 | Jackson County Memorial Hospital Authority | Clinic/Center | 101 S Park Ln, Suite 200, Altus, OK 73521-5731 | 2015-07-18 |
| 1407230790 | Jackson County Memorial Hospital Authority | Clinic/Center | 101 S Park Ln, Suite 100, Altus, OK 73521-5731 | 2015-07-16 |
| 1093199382 | Jackson County Memorial Hospital Authority | Clinic/Center | 114 S Louis Tittle Ave, Mangum, OK 73554-4406 | 2015-07-16 |
| 1912138553 | Jackson County Memorial Hospital Authority | Clinic/Center | 1001 Us Highway 83 N, Childress, TX 79201-2322 | 2009-07-30 |
| 1003094129 | Jackson County Memorial Hospital Authority | General Acute Care Hospital | 400 E Chestnut St, Hollis, OK 73550-2030 | 2008-01-31 |
| 1235170754 | Jackson County Memorial Hospital Authority | Hospice Care, Community Based | 1204 E Tamarack Rd, Altus, OK 73521-1234 | 2006-06-08 |
| 1093763781 | Jackson County Memorial Hospital Authority | General Acute Care Hospital | 1200 E Pecan St, Altus, OK 73521-6141 | 2006-05-04 |
| 1295735991 | Jackson County Memorial Hospital Authority | General Acute Care Hospital | 400 E Chestnut St, Hollis, OK 73550-2030 | 2005-07-26 |
| Street Address |
205 S PARK LN |
| City | ALTUS |
| State | OK |
| Zip Code | 73521-5755 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013988179 | Carol Marie Sherman | Family Medicine | 205 S Park Ln, Altus, OK 73521 | 2006-01-27 |
| 1013542406 | Jorge Cardenas | Registered Nurse | 205 S Park Ln, Altus, OK 73521-5755 | 2020-03-06 |
| 1295230209 | Kristi Nicole Fry | Nurse Practitioner | 205 S Park Ln, Altus, OK 73521-5755 | 2018-03-30 |
| 1063809531 | Rose Ngishu | Internal Medicine | 205 S Park Ln, Altus, OK 73521 | 2015-04-22 |
| 1053711648 | Kelley Duncan | Occupational Therapist | 205 S Park Ln, Suite 100, Altus, OK 73521-5755 | 2014-09-02 |
| 1740619899 | Gabrielle Daniel Arndt | Physician Assistant | 205 S Park Ln, Suite 210, Altus, OK 73521-5755 | 2013-11-08 |
| 1932535846 | Elizabeth Maurene Lauterbach | Physician Assistant | 205 S Park Ln, Altus, OK 73521-5755 | 2013-09-24 |
| 1528322476 | Alejandro Pacheco | Family Medicine | 205 S Park Ln, Altus, OK 73521-5755 | 2012-06-26 |
| 1093021016 | Ama Isaac | Family Medicine | 205 S Park Ln, Suite 210, Altus, OK 73521-5755 | 2010-08-27 |
| 1275847303 | Lonnie Edwin Perryman Jr. | Family Medicine | 205 S Park Ln, Altus, OK 73521-5755 | 2010-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982263752 | Shortgrass Community Health Center, Inc | Clinic/Center | 211 East Broadway, Altus, OK 73521 | 2019-06-06 |
| 1598025827 | Dustin James Robins | Counselor | 1052 E Cherry St, Altus, OK 73521 | 2012-05-21 |
| 1831471101 | Manda Lea Stephens | Nurse Practitioner | 205 S. Park Lane, Altus, OK 73521 | 2011-09-13 |
| 1649439167 | Lisa Michelle Shelton | Pharmacist | 2500 N Main, Altus, OK 73521 | 2008-06-09 |
| 1114192911 | Richard G. Henry | Health Maintenance Organization | 112 Val Verde, Altus, OK 73521 | 2008-04-23 |
| 1194881060 | Resters Diabetic Shoes and Home Medical | Durable Medical Equipment & Medical Supplies | 103 West Commerce Street, Altus, OK 73521 | 2006-12-28 |
| 1265592141 | Noble L Ballard.medical Clinic, Pllc | Family Medicine | 1015 East Broadway Street, Stuite 101, Altus, OK 73521 | 2006-12-11 |
| 1457377822 | Comanche County Healthcare | Family Medicine | 3000 N Main St, Suite A, Altus, OK 73521 | 2006-07-15 |
| 1326095381 | Charles C Carter Md Dph Pllc | Family Medicine | 1015 E Broadway St, Suite 102, Altus, OK 73521 | 2006-05-27 |
| 1235112426 | Air Evac Ems Inc | Ambulance | 6333 N Main Street, Altus, OK 73521 | 2005-11-22 |
| Find all providers in zip 73521 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972987014 | Jackson County Memorial Hospital Authority | Clinic/Center | 101 S Park Ln, Suite 200, Altus, OK 73521-5731 | 2015-07-18 |
| 1407230790 | Jackson County Memorial Hospital Authority | Clinic/Center | 101 S Park Ln, Suite 100, Altus, OK 73521-5731 | 2015-07-16 |
| 1568479871 | Johnson Optical Dispensary | Clinic/Center | 1003 N Main St, Suite A, Altus, OK 73521-3119 | 2006-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093312548 | Prime Health Associates, Pllc | Clinic/Center | 2511 Alexa Ave, Edmond, OK 73034-3458 | 2020-10-07 |
| 1598387524 | Thomas E. Cashero Md LLC | Clinic/Center | 90 N 30th St Ste 5, Clinton, OK 73601-3100 | 2020-05-13 |
| 1184271793 | Healthy Skin Dermatology of Oklahoma Pllc | Clinic/Center | 13933 Technology Dr Ste B, Oklahoma City, OK 73134-1053 | 2019-08-20 |
| 1922572809 | Endovascular Consulting Solutions | Clinic/Center | 1705 E 19th St Ste 410, Tulsa, OK 74104-5415 | 2019-01-14 |
| 1831610641 | Scot A Sullivan Md PC | Clinic/Center | 2020 E 15th St Ste B, Edmond, OK 73013-6749 | 2017-06-30 |
| 1053862102 | Okc Neurology-catherine E Porter Md, Pllc | Clinic/Center | 6701 W Hefner Rd Ste B, Oklahoma City, OK 73162-4706 | 2016-10-24 |
| 1730584509 | Digital Diagnostic Solutions LLC | Clinic/Center | 5017 S Frontage Road, Tulsa, OK 74107-8976 | 2014-10-23 |
| 1891102331 | Panhandle Counseling and Health Center, Inc. | Clinic/Center | 5170 Patricia Blvd, Guymon, OK 73942-0000 | 2014-07-16 |
| 1922350719 | Allergy Arts of Oklahoma Pllc | Clinic/Center | 3300 Nw 56th St Ste 100, Oklahoma City, OK 73112-4538 | 2012-10-04 |
| 1255699112 | Meghan E. Scears, Md, Pllc | Clinic/Center | 808 24th Ave Nw Ste 202, Norman, OK 73069-6204 | 2012-04-30 |
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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.