ST JOHN MEDICAL CENTER INC (NPI# 1578656161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578656161 |
| Entity Type | Organization |
| Organization Name | ST JOHN MEDICAL CENTER INC |
| Other Organization Name | BERNSEN REHAB |
| Practice Address |
1923 S Utica Ave Tulsa OK 74104-6520 |
| Practice Telephone | 9187442345 |
| Mailing Telephone | 9187442345 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2010-11-10 |
| Authorized Official Name | SR. M. THERESE GOTTSCHALK (PRESIDENT/CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9187442180 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273Y00000X | Rehabilitation Unit | 2265 | OK | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100699400A | 05 | |
| OK | BCBS OF OK | 000370114001 | 01 |
| OK | CHAMPUS | 74104 0000 | 01 |
| Other Name | Type Code |
|---|---|
| Bernsen Rehab | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144306382 | St John Medical Center Inc | Psychiatric Unit | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2006-10-31 |
| 1154417368 | St John Medical Center Inc | General Acute Care Hospital | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2006-10-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ST JOHN MEDICAL CENTER INC | 1923 S Utica Ave, Tulsa, OK 74104-6520 |
| Street Address |
1923 S UTICA AVE |
| City | TULSA |
| State | OK |
| Zip Code | 74104-6520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174527667 | Mark Douglas Mills | Pharmacist | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2005-06-13 |
| 1043848880 | Saba Imani | Student in an Organized Health Care Education/Training Program | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2020-03-28 |
| 1073146312 | Tammy Irene Joplin | Clinical Nurse Specialist | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2020-02-14 |
| 1962047563 | Houston Reed Slemp | Nurse Practitioner | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-11-07 |
| 1558903369 | Nicole Coburn | Physician Assistant | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-10-14 |
| 1124669643 | Jordan Beasley | Physician Assistant | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-10-06 |
| 1558926683 | Jacob Blasdel | Student in an Organized Health Care Education/Training Program | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-05-03 |
| 1487217634 | Candice R Rogers | Student in an Organized Health Care Education/Training Program | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-04-15 |
| 1881158178 | Ellen Chadick | Anesthesiologist Assistant | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-01-30 |
| 1528522810 | Hannah Chadick | Anesthesiologist Assistant | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-01-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982253811 | Ultimate Health and Pain Management | Pain Medicine | 1844 East 15th Street, Tulsa, OK 74104 | 2019-09-04 |
| 1225691223 | David Murray | Student in an Organized Health Care Education/Training Program | 2100 S Wheeling Ave, Tulsa, OK 74104 | 2019-04-16 |
| 1083115828 | Susan Fortner | Counselor | 1328 S. Delaware Pl, Tulsa, OK 74104 | 2018-02-27 |
| 1033636915 | Mark Brizendine | Dietitian, Registered | Hillcrest Medical Center 1120 S. Utica Ave, Tulsa, OK 74104 | 2017-08-23 |
| 1295259067 | Demi Reyd Cook | Nurse Practitioner | 1717 A South Utica, Tulsa, OK 74104 | 2017-08-02 |
| 1851827059 | Oklahoma Cvs Pharmacy | Durable Medical Equipment & Medical Supplies | 1701 E 15th Street, Tulsa, OK 74104 | 2017-05-08 |
| 1801334982 | Jamie Lynne Miller | Internal Medicine | 2000 S. Wheeling Avenue Ste 510, Tulsa, OK 74104 | 2017-02-08 |
| 1578913430 | Donna Durant-macon | Registered Nurse | 315 South Utica, Tulsa, OK 74104 | 2016-06-21 |
| 1669833851 | Mbc Dental | Dentist | 401 S. Utica Ave, #a, Tulsa, OK 74104 | 2016-03-15 |
| 1518332170 | Neuro Dynamics LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 22 S Lewis, Tulsa, OK 74104 | 2015-12-08 |
| Find all providers in zip 74104 | ||||
| Taxonomy Code | 273Y00000X |
| Grouping | Hospital Units |
| Classification | Rehabilitation Unit |
| In general, a distinct unit of a general acute care hospital that provides care encompassing a comprehensive array of restoration services for the disabled and all support services necessary to help patients attain their maximum functional capacity. Source: AHA Annual Survey p. A10 1996 AHA Guide. For Medicare, a distinct part of a general acute care hospital providing inpatient rehabilitation services that meets the following requirements. Rehabilitation Units have in effect a preadmission screening procedure under which each prospective patient’s condition and medical history are reviewed to determine whether the patient is likely to benefit significantly from an intensive inpatient program or assessment; ensure that the patients receive close medical supervision and furnish, through the use of qualified personnel, rehabilitation nursing, physical therapy and occupational therapy, plus, as needed, speech therapy, social services or psychological services and orthotic and prosthetic services; have a plan of treatment for each inpatient that is established, reviewed, and revised as needed by a physician in consultation with other professional personnel who provide services to the patient; use a coordinated multidisciplinary team approach in the rehabilitation of each inpatient, as documented by periodic clinical entries made in the patient’s medical record to note the patient's status in relationship to goal attainment, and that team conferences are held at least every two weeks to determine the appropriateness of treatment; have a director of rehabilitation who provides services to the unit and its inpatients for at least 20 hours a week, is a doctor of medicine or osteopathy, is licensed under State law to practice medicine or surgery, and has had, after completing a one-year hospital internship at least two years of training or experience in the medical management of inpatients requiring rehabilitation services. |
| Notes: Source: Code of Federal Regulations #42, Section 412.29. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023064300 | Brookhaven Hospital Inc. | Rehabilitation Unit | 201 S Garnett Rd, Tulsa, OK 74128 | 2006-05-26 |
| 1003039488 | Saint Francis Hospital, Inc. | Rehabilitation Unit | 6161 S Yale Ave, Tulsa, OK 74136-1902 | 2007-04-11 |
| 1679652192 | Ahs Hillcrest Medical Center LLC | Rehabilitation Unit | 1120 S Utica Ave, Tulsa, OK 74104-4012 | 2006-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740716018 | Jai Shree Hanuman, LLC | Rehabilitation Unit | 6101 N Santa Fe Ave, Oklahoma City, OK 73118-7526 | 2017-05-05 |
| 1659398618 | Comanche County Healthcare Corporation Dba Center for Occupational Hea | Rehabilitation Unit | 602 Se Wallock St, Lawton, OK 73501-5444 | 2006-07-16 |
| 1033113097 | St. Anthony Shawnee Hospital, Inc | Rehabilitation Unit | 1900 S Gordon Cooper Dr, Shawnee, OK 74801 | 2005-06-08 |
| 1831663657 | Integris Baptist Medical Center, Inc | Rehabilitation Unit | 5501 N Portland Ave, Oklahoma City, OK 73112-2074 | 2019-01-15 |
| 1306381561 | Saint Francis Hospital Muskogee Inc | Rehabilitation Unit | 300 Rockefeller Dr, Muskogee, OK 74401-5075 | 2016-12-27 |
| 1932442019 | Mercy Hospital Ada, Inc | Rehabilitation Unit | 430 N Monte Vista St, Ada, OK 74820-4610 | 2013-03-27 |
| 1811193964 | Linda Sue Church | Rehabilitation Unit | 3401 W Gore Blvd, Lawton, OK 73505-6332 | 2007-06-25 |
| 1053456111 | Jane Phillips Memorial Medical Center, Inc | Rehabilitation Unit | 3500 E Frank Phillips Blvd, Bartlesville, OK 74006-2411 | 2007-02-20 |
| 1083757926 | Muskogee Regional Medical Center LLC | Rehabilitation Unit | 300 Rockefeller Dr, Muskogee, OK 74401-5075 | 2007-02-14 |
| 1538213764 | Mcbride Clinic Orthopedic Hospital, LLC | Rehabilitation Unit | 9600 Broadway Ext, Oklahoma City, OK 73114-7408 | 2007-01-23 |
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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.