WAGONER HOSPITAL AUTHORITY (NPI# 1568808988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568808988 |
| Entity Type | Organization |
| Organization Name | WAGONER HOSPITAL AUTHORITY |
| Practice Address |
3501 W Broadway St Muskogee OK 74401-2138 |
| Mailing Address |
1200 W Cherokee St Wagoner OK 74467-4624 |
| Practice Telephone | 9189139408 |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2018-03-07 |
| Authorized Official Name | DEBI HAMILTON (CHAIRMAN) |
| Authorized Official Telephone | 9184855514 |
| Is Organization Subpart | Y |
| Parent Organization Name | WAGONER HOSPITAL AUTHORITY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 2298 | OK | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200100890A | 05 | |
| OK | 200100890B | 05 | |
| MEDICARE CLINIC PROVIDER NUMBER | 300522264 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366674772 | Wagoner Hospital Authority | Clinic/Center | 3501 W Broadway St, Muskogee, OK 74401-2138 | 2009-08-18 |
| 1386611580 | Wagoner Hospital Authority | General Acute Care Hospital | 1200 W Cherokee St, Wagoner, OK 74467-4624 | 2006-03-07 |
| Street Address |
3501 W BROADWAY ST |
| City | MUSKOGEE |
| State | OK |
| Zip Code | 74401-2138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013031632 | Michael W Hammond, M.d. | Family Medicine | 3501 W Broadway St, Muskogee, OK 74401-2138 | 2007-03-19 |
| 1366674772 | Wagoner Hospital Authority | Clinic/Center | 3501 W Broadway St, Muskogee, OK 74401-2138 | 2009-08-18 |
| 1841428752 | Srinivas Mahesh Katta | Internal Medicine | 3501 W Broadway St, Muskogee, OK 74401-2138 | 2009-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508486978 | Economy Pharmacy | Pharmacy | 3414 W. Okmulgee, Muskogee, OK 74401 | 2020-04-25 |
| 1831678390 | Jaclyn Drass | Nurse Practitioner | 201 N 32nd St, Muskogee, OK 74401 | 2018-08-07 |
| 1225530710 | Cliffetta J Harrison | Case Management | 619 N Main St., Muskogee, OK 74401 | 2018-03-01 |
| 1255700720 | Wesley B Higgs | Physical Therapist | 151 Eco-friendly Drive, Suite 101, Muskogee, OK 74401 | 2015-09-15 |
| 1699163626 | Dependable Medical Diagnostics LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 122 S. 38th, Muskoqee, OK 74401 | 2014-12-29 |
| 1134529928 | Mednow Urgent Care Center LLC | Clinic/Center | 550 W Shawnee St, Muskogee, OK 74401 | 2014-08-28 |
| 1447676770 | Ruby Johns | Counselor | 403 N 24th, Muskogee, OK 74401 | 2014-03-11 |
| 1417393380 | Andreka Pace | Counselor | 223 W Southside Boulevard, Muskogee, OK 74401 | 2013-05-17 |
| 1730438342 | Gordon Keith Harlin | Social Worker | 619 N Main, Muskogee, OK 74401 | 2012-08-29 |
| 1740565928 | Channing Kathleen Burke | Counselor | 741 South 32nd Street, Muskogee, OK 74401 | 2011-10-19 |
| Find all providers in zip 74401 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801449400 | Osu Center for Health Sciences | Clinic/Center | 3101 Chandler Rd Ste 101, Muskogee, OK 74403-4955 | 2019-07-23 |
| 1245713734 | Osu Center for Health Sciences | Clinic/Center | 2024 W Broadway St, Muskogee, OK 74401-2758 | 2018-09-11 |
| 1215381892 | Osu Center for Health Sciences | Clinic/Center | 3131 Military Blvd, Muskogee, OK 74401-2290 | 2016-04-20 |
| 1053792093 | Children's Clinic, Pllc | Clinic/Center | 3101 Chandler Rd Ste 101, Muskogee, OK 74403-4955 | 2015-06-16 |
| 1730560699 | Premier Pediatric and Adolescent Care | Clinic/Center | 2009 N Main St, Muskogee, OK 74401 | 2015-06-16 |
| 1124413075 | Osu Center for Health Sciences | Clinic/Center | 2009 N Main St, Muskogee, OK 74401-4131 | 2015-03-30 |
| 1518234046 | Osu Center for Health Sciences | Clinic/Center | 3131 Military Blvd, Muskogee, OK 74401-2290 | 2011-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275471 | Osu Center for Health Sciences | Clinic/Center | 1 E Clark Bass Blvd Ste 201, Mcalester, OK 74501-4209 | 2020-11-06 |
| 1427662170 | Osu Center for Health Sciences | Clinic/Center | 802 S Jackson Ave Ste 410, Tulsa, OK 74127-9059 | 2020-09-01 |
| 1154949642 | Osu Center for Health Sciences | Clinic/Center | 140 W 151st St S, Glenpool, OK 74033-4523 | 2020-07-10 |
| 1235757071 | Equality Health Group LLC | Clinic/Center | 4301 Nw 63rd St Ste 109, Oklahoma City, OK 73116-1548 | 2020-07-08 |
| 1538785985 | Stars and Stripes Therapy Inc. | Clinic/Center | 713 Sw C Ave Ste A, Lawton, OK 73501-4311 | 2020-06-22 |
| 1265058101 | Taylor Medical Group, LLP | Clinic/Center | 735 W Locust St, Stilwell, OK 74960-3403 | 2020-06-16 |
| 1891317731 | Sparks Medical Consulting LLC | Clinic/Center | 1604 Sw 38th St, Moore, OK 73160-2953 | 2020-05-14 |
| 1093341844 | Osu Center for Health Sciences | Clinic/Center | 3201 W Gore Blvd Ste G2, Lawton, OK 73505-6323 | 2020-03-12 |
| 1255964128 | Osu Center for Health Sciences | Clinic/Center | 110 Nw 31st St Fl 3, Lawton, OK 73505-6100 | 2020-02-19 |
| 1104458231 | Osu Center for Health Sciences | Clinic/Center | 6501 S Western Ave Ste 101, Oklahoma City, OK 73139-1709 | 2020-02-06 |
| Find all providers with the same taxonomy | ||||
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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.