GRADY MEMORIAL HOSPITAL (NPI# 1164859260) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164859260 |
| Entity Type | Organization |
| Organization Name | GRADY MEMORIAL HOSPITAL |
| Other Organization Name | FIVE OAKS FAMILY MEDICAL CLINIC |
| Practice Address |
2100 W Iowa Ave Suite A Chickasha OK 73018-2736 |
| Practice Telephone | 4052242100 |
| Practice Fax Number | 4057792346 |
| Mailing Telephone | 4052242100 |
| Mailing Fax Number | 4057792346 |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2017-09-05 |
| Authorized Official Name | WARREN KEAN SPELLMAN (CEO) |
| Authorized Official Telephone | 4057792150 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | OK | Allopathic & Osteopathic Physicians | |
| N | 207V00000X | Obstetrics & Gynecology | OK | Allopathic & Osteopathic Physicians | |
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
OK | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100700820 K | 05 |
| Other Name | Type Code |
|---|---|
| Five Oaks Family Medical Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619991098 | Grady Memorial Hospital | Durable Medical Equipment & Medical Supplies | 2100 W Iowa Ave Ste A, Chickasha, OK 73018-2736 | 2006-07-27 |
| 1578592788 | Grady Memorial Hospital | Family Medicine | 113 South Rush Ave, Rush Springs, OK 73082-0277 | 2006-07-01 |
| 1538169198 | Grady Memorial Hospital | General Acute Care Hospital | 2220 W Iowa Ave, Chickasha, OK 73018-2738 | 2005-07-26 |
| 1164941324 | Grady Memorial Hospital | Clinic/Center | 3200 Quail Springs Pkwy Ste 200, Oklahoma City, OK 73134-2699 | 2017-09-19 |
| 1073032660 | Grady Memorial Hospital | Podiatrist | 2815 W Elk Ave, Duncan, OK 73533-1517 | 2017-09-14 |
| 1437698784 | Grady Memorial Hospital | Surgery | 1104 E Central Blvd, Anadarko, OK 73005-4406 | 2017-02-20 |
| 1821467069 | Grady Memorial Hospital | Nurse Anesthetist, Certified Registered | 1002 E Central Blvd, Anadarko, OK 73005-4405 | 2015-09-17 |
| 1740659986 | Grady Memorial Hospital | Nurse Anesthetist, Certified Registered | 1407 N Whisenant Dr, Duncan, OK 73533-1650 | 2015-09-17 |
| 1578930871 | Grady Memorial Hospital | Orthopaedic Surgery | 1407 N Whisenant Dr, Duncan, OK 73533-1650 | 2015-08-22 |
| 1407252596 | Grady Memorial Hospital | General Practice | 1002 E Central Blvd, Anadarko, OK 73005-4405 | 2014-11-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | GRADY MEMORIAL HOSPITAL | 2220 Iowa Ave, Chickasha, OK 73018-2738 |
| Oklahoma Business Registrations | GRADY MEMORIAL HOSPITAL FOUNDATION, INC | 2220 Iowa Ave, Chickasha, OK 73018 |
| Oklahoma Business Registrations | GRADY MEMORIAL HOSPITAL FOUNDATION, INC. |
| Street Address |
2100 W IOWA AVE SUITE A |
| City | CHICKASHA |
| State | OK |
| Zip Code | 73018-2736 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902887482 | Mitchell D Coppedge | Family Medicine | 2100 W Iowa Ave, Suite A, Chickasha, OK 73018-2736 | 2005-11-10 |
| 1639784176 | Foot & Ankle Surgeons of Oklahoma Pllc | Podiatrist | 2100 W Iowa Ave, Chickasha, OK 73018-2736 | 2020-09-11 |
| 1245619006 | Jerrus Harris | Nurse Practitioner | 2100 W Iowa Ave, Suite A, Chickasha, OK 73018-2736 | 2015-05-27 |
| 1699199984 | Delanie Berry | Nurse Practitioner | 2100 W Iowa Ave, Suite A, Chickasha, OK 73018-2736 | 2014-02-07 |
| 1669775714 | Laura Louise Kadechuk | Physician Assistant | 2100 W Iowa Ave, Suite A, Chickasha, OK 73018-2736 | 2010-12-13 |
| 1457654519 | Mary A. Ross | Physician Assistant | 2100 W Iowa Ave, Suite A, Chickasha, OK 73018-2736 | 2010-12-13 |
| 1982925913 | Bridget Diane Bryan | Pediatrics | 2100 W Iowa Ave, Suite A, Chickasha, OK 73018-2736 | 2010-06-14 |
| 1235459413 | James Stephens | Pain Medicine | 2100 W Iowa Ave, Chickasha, OK 73018-2736 | 2010-06-10 |
| 1023336542 | Abby Marie Housman | Family Medicine | 2100 W Iowa Ave, Suite A, Chickasha, OK 73018-2736 | 2010-05-07 |
| 1275859621 | Diadra Lorseh | Physician Assistant | 2100 W Iowa Ave, Chickasha, OK 73018-2736 | 2010-04-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821528662 | Cancer Centers of Southwest Oklahoma, LLC | Internal Medicine | 210 South Mary Bailey Drive, Chickasha, OK 73018 | 2017-06-14 |
| 1821535915 | Around The Clock Home Care | In Home Supportive Care | 313 W Chickasha Ave, Chickasha, OK 73018 | 2017-01-26 |
| 1639535537 | Teagan Rae Dorsey | Registered Nurse | 304 S 29th Street, Chickasha, OK 73018 | 2016-01-07 |
| 1578949327 | Megan Griffin | Dentist | 720 West Grand Ave, Chickasha, OK 73018 | 2015-08-04 |
| 1174933709 | Mendy Stone | Case Manager/Care Coordinator | 1820 Wets Idaho Ave, Chickasha, OK 73018 | 2014-05-05 |
| 1407286735 | Martha Allison Shadoan | Social Worker | 804 W. Choctaw, Chickasha, OK 73018 | 2013-11-22 |
| 1225313521 | Shanna Michelle Rice | Counselor | 198 East Almar Drive, Chickasha, OK 73018 | 2011-10-18 |
| 1306016175 | Logsdon Chiropractic, Pllc | Clinic/Center | 1807 S. 9th, Chickasha, OK 73018 | 2008-03-07 |
| 1518148337 | Christopher Lee Ludwell | Chiropractor | 419 Fieldcrest, Chickasha, OK 73018 | 2007-11-20 |
| 1902098270 | Barbara Ann Reilley Schmidt | Pediatrics | 2222 West Iowa, Chickasha, OK 73018 | 2007-08-10 |
| Find all providers in zip 73018 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| 1275161457 | Drumright Community Hospital LLC | Clinic/Center | 612 W Bypass, Drumright, OK 74030-5957 | 2020-04-01 |
| 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 |
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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.