STILLWATER MEDICAL CENTER AUTHORITY (NPI# 1558377135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558377135 |
| Entity Type | Organization |
| Organization Name | STILLWATER MEDICAL CENTER AUTHORITY |
| Practice Address |
1323 W 6th Ave Stillwater OK 74074-4306 |
| Mailing Address |
Po Box 1209 Stillwater OK 74076-1209 |
| Practice Telephone | 4053721480 |
| Practice Fax Number | 4057424990 |
| Mailing Telephone | 4053721480 |
| Mailing Fax Number | 4057424990 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2011-07-14 |
| Authorized Official Name | MR. JERRY G MOELLER (CEO) |
| Authorized Official Telephone | 4057425701 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 2084P2900X |
Psychiatry & Neurology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 208M00000X | Hospitalist | Allopathic & Osteopathic Physicians | ||
| N | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians | ||
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians | ||
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538798897 | Stillwater Medical Center Authority | Clinic/Center | 1411 W 7th Ave Ste 201, Stillwater, OK 74074-4300 | 2020-04-07 |
| 1982237244 | Stillwater Medical Center Authority | Clinic/Center | 1116 Manvel Ave, Chandler, OK 74834-3856 | 2020-02-14 |
| 1366075616 | Stillwater Medical Center Authority | Clinic/Center | 505 E Highway 33, Perkins, OK 74059-4520 | 2020-02-14 |
| 1336772680 | Stillwater Medical Center Authority | Clinic/Center | 518 E Lakeview Rd, Stillwater, OK 74075-2825 | 2020-02-14 |
| 1447883780 | Stillwater Medical Center Authority | Clinic/Center | 600 S Linwood Ave Ste A, Cushing, OK 74023-4630 | 2020-02-14 |
| 1407937220 | Stillwater Medical Center Authority | Durable Medical Equipment & Medical Supplies | 1200 S Adams St, Stillwater, OK 74074 | 2006-10-18 |
| 1871567958 | Stillwater Medical Center Authority | Home Health | 1201 S. Adams, Stillwater, OK 74074-4225 | 2006-02-15 |
| 1255943114 | Stillwater Medical Center Authority | Clinic/Center | 300 Boulder St, Pawnee, OK 74058-3801 | 2020-08-20 |
| 1457961567 | Stillwater Medical Center Authority | Clinic/Center | 1411 W 7th Ave Ste 102, Stillwater, OK 74074-4300 | 2020-08-04 |
| 1518577675 | Stillwater Medical Center Authority | Clinic/Center | 2340 E Main St, Cushing, OK 74023-2905 | 2020-08-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | STILLWATER MEDICAL CENTER AUTHORITY | 117 S Main St, Perkins, OK 74059 |
| Street Address |
1323 W 6TH AVE |
| City | STILLWATER |
| State | OK |
| Zip Code | 74074-4306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982685608 | Brandon Scott Hetzler | Specialist/Technologist | 1323 W 6th Ave, Stillwater, OK 74074-4306 | 2005-11-09 |
| 1811508146 | Aimee Marie Kehres | Registered Nurse | 1323 W 6th Ave, Stillwater, OK 74074-4306 | 2020-08-11 |
| 1144868688 | Megan Kelly | Dietitian, Registered | 1323 W 6th Ave, Stillwater, OK 74074-4306 | 2019-12-16 |
| 1295394757 | Amber Noel Burnett | Registered Nurse | 1323 W 6th Ave, Stillwater, OK 74074-4306 | 2019-06-10 |
| 1437610094 | Kyndell Denise Weder | Physician Assistant | 1323 W 6th Ave, Stillwater, OK 74074-4306 | 2019-03-27 |
| 1124545538 | Emily Emerson | Dietitian, Registered | 1323 W 6th Ave, Stillwater, OK 74074-4306 | 2017-08-25 |
| 1134660210 | Osu Center for Health Sciences | Clinic/Center | 1323 W 6th Ave, Stillwater, OK 74074-4306 | 2017-03-09 |
| 1548616295 | Cassie Elizabeth Davis | Registered Nurse | 1323 W 6th Ave, Stillwater, OK 74074-4306 | 2016-05-12 |
| 1013392737 | Debra O'day | Nurse Practitioner | 1323 W 6th Ave, Stillwater, OK 74074-4306 | 2015-07-23 |
| 1700295136 | Sarah Walker | Dietitian, Registered | 1323 W 6th Ave, Stillwater, OK 74074 | 2014-08-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366090680 | Jason K. White, Ph.d., LLC | Psychologist | 807 S. Pine St., Stillwater, OK 74074 | 2019-08-29 |
| 1366095861 | Kelsey Lyn Bigheart | Peer Specialist | 5421 S Deer Trail, Stillwater, OK 74074 | 2019-07-23 |
| 1881256691 | Shelly Lynn Green | Nurse Practitioner | 1321 W. 7th Street, Stillwater, OK 74074 | 2019-07-01 |
| 1811426273 | Judy Catlett | Case Manager/Care Coordinator | 800 E. 6th Str, Stillwater, OK 74074 | 2017-06-08 |
| 1518322296 | Abi Physical Therapy Services | Physical Therapist | 810 S. Walnut Street, Stillwater, OK 74074 | 2015-12-22 |
| 1366833451 | Connecting The Pieces | Case Management | 812 S Walnut, Stillwater, OK 74074 | 2015-02-10 |
| 1790122414 | Airie Flanagan | Doula | 2601 Gregory Ln, Stillwater, OK 74074 | 2013-06-04 |
| 1760720668 | Stillwater Histology LLC | Internal Medicine | 1301 W. 6th St, Suite 106, Stillwater, OK 74074 | 2013-01-28 |
| 1144570565 | Nikkie Jo Dunnigan | Counselor | 2322 W 7th, Stillwater, OK 74074 | 2012-09-13 |
| 1487889952 | Lynn B. Roberts | General Practice | 1321 W 7th St, Stillwater Community Health, Stillwater, OK 74074 | 2009-05-27 |
| Find all providers in zip 74074 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912480971 | Samaritan Hospital of Troy, New York | Family Medicine | 1111 Hudson Avenue, Stillwater, NY 12170-3439 | 2018-09-14 |
| 1336657022 | Brandi Watts | Family Medicine | 1523 W 9th Ave, Stillwater, OK 74074-5469 | 2018-01-16 |
| 1578932943 | Group Health Plan, Inc | Family Medicine | 921 Greeley Street, Stillwater, MN 55082 | 2015-09-16 |
| 1003149139 | Oca Stillwater Lp | Family Medicine | 275 S Perkins Rd, Stillwater, OK 74074-3665 | 2009-09-08 |
| 1184871295 | Jon Stratte | Family Medicine | 114 Lakeside Dr, Stillwater, MN 55082-4238 | 2008-08-20 |
| 1215125489 | Paul Vincent Quinn | Family Medicine | 9991 Arcola Ct N, Stillwater, MN 55082-9523 | 2007-10-11 |
| 1972527422 | Andrew D Maas | Family Medicine | 270 Main N St 300, Stillwater, MN 55082-6788 | 2006-07-27 |
| 1558384511 | Jessica A Davis | Family Medicine | 781 Hudson Avenue, Suite 2, Stillwater, NY 12170 | 2006-07-25 |
| 1275566358 | Wesley Andrews | Family Medicine | O S U Student Health Service, 1202 W. Farm Road, Stillwater, OK 74078-2036 | 2006-07-09 |
| 1114967288 | Kenneth Evans | Family Medicine | 8821 W 6th Ave, Stillwater, OK 74074-1094 | 2006-06-07 |
| Find all providers in STILLWATER | ||||
| City | STILLWATER |
| Zip Code | 74074 |
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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.