OKLAHOMA STATE UNIVERSITY MEDICAL CENTER TRUST (NPI# 1477813707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477813707 |
| Entity Type | Organization |
| Organization Name | OKLAHOMA STATE UNIVERSITY MEDICAL CENTER TRUST |
| Other Organization Name | OKLAHOMA STATE UNIVERSITY MEDICAL CENTER |
| Practice Address |
744 W 9th St Tulsa OK 74127-9020 |
| Practice Telephone | 9185872561 |
| Practice Fax Number | 9185991750 |
| Mailing Telephone | 9185872561 |
| Mailing Fax Number | 9185991750 |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2012-05-21 |
| Authorized Official Name | MR. JERRY L. HUDSON (TRUSTEE CHAIRMAN) |
| Authorized Official Telephone | 9184924418 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | 2260 | OK | Hospital Units |
| Other Name | Type Code |
|---|---|
| Oklahoma State University Medical Center | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013158476 | Oklahoma State University Medical Center Trust | Clinic/Center | 744 W 9th St, Tulsa, OK 74127-9020 | 2009-03-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | OKLAHOMA STATE UNIVERSITY MEDICAL CENTER TRUST | *********, ** ****** |
| Street Address |
744 W 9TH ST |
| City | TULSA |
| State | OK |
| Zip Code | 74127-9020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013914456 | Judith Wolfstein | Specialist | 744 W 9th St, Tulsa, OK 74127-9020 | 2005-06-30 |
| 1053924118 | Zachary Dunn | Pharmacist | 744 W 9th St, Tulsa, OK 74127-9907 | 2020-08-28 |
| 1104449370 | Laura Ann Holliday | Pharmacist | 744 W 9th St, Tulsa, OK 74127-9907 | 2020-05-22 |
| 1033732623 | Ashlyn Renee Terrell | Student in an Organized Health Care Education/Training Program | 744 W 9th St, Tulsa, OK 74127-9907 | 2020-05-18 |
| 1366061780 | Joshua M Day | Student in an Organized Health Care Education/Training Program | 744 W 9th St, Tulsa, OK 74127-9907 | 2020-04-15 |
| 1639798150 | Nathan Nelson | Student in an Organized Health Care Education/Training Program | 744 W 9th St, Tulsa, OK 74127-9907 | 2020-04-14 |
| 1801415328 | Jake Xavier Checketts | Student in an Organized Health Care Education/Training Program | 744 W 9th St, Tulsa, OK 74127-9907 | 2020-04-14 |
| 1780203505 | Coy Yasler | Student in an Organized Health Care Education/Training Program | 744 W 9th St, Tulsa, OK 74127-9907 | 2020-04-11 |
| 1548889553 | Lacy Shireen Brame | Student in an Organized Health Care Education/Training Program | 744 W 9th St, Tulsa, OK 74127-9907 | 2020-04-09 |
| 1659900421 | Heath Spencer | Student in an Organized Health Care Education/Training Program | 744 W 9th St, Tulsa, OK 74127-9907 | 2020-04-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366966699 | Tarell Lynell Earl | Case Manager/Care Coordinator | 602 N. 28th W. Pl., Tulsa, OK 74127 | 2017-07-28 |
| 1023538014 | Milton Dean IIi | Counselor | 1234 N Rosedale, Tulsa, OK 74127 | 2017-06-21 |
| 1740700988 | Lisa Lee Ann Gilliland | Case Manager/Care Coordinator | 2001 W Ute Pl, Tulsa, OK 74127 | 2017-06-20 |
| 1114456498 | Kevin Thomas Jackson | Counselor | 310 S 49th W Ave, Tulsa, OK 74127 | 2017-06-08 |
| 1427406180 | Byron Conrad Dixon Jr. | Case Manager/Care Coordinator | 551 N. 28th W. Ave., Tulsa, OK 74127 | 2016-06-02 |
| 1548621568 | Brandon Worth | Student in an Organized Health Care Education/Training Program | 717 S. Houston Ave., Suite 400, Tulsa, OK 74127 | 2016-03-18 |
| 1073987467 | Jo Lowe | Social Worker | 420 S. Lawton Ave. Apt 315, Tulsa, OK 74127 | 2015-11-23 |
| 1154718575 | William Hughes | Health Educator | 3101 W Edison, Tulsa, OK 74127 | 2015-04-23 |
| 1801289665 | Kristyn Janelle Zrenda | Student in an Organized Health Care Education/Training Program | 717 S. Houston Ave., Suite 400, Tulsa, OK 74127 | 2015-03-17 |
| 1831595719 | Mallory Yarbrough | Counselor | 3005 N 24th West Ave, Tulsa, OK 74127 | 2014-11-05 |
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| 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 |
|---|---|---|---|---|
| 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 |
| 1144306382 | St John Medical Center Inc | Psychiatric Unit | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2006-10-31 |
| 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 |
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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.