UTICA PARK CLINIC PRIMARY CARE
NPI 1295232478
Clinic/Center - Rural Health in Henryetta, OK

Q: What is Ahs Henryetta Hospital LLC's NPI number?

The NPI number for Ahs Henryetta Hospital LLC is 1295232478. It was assigned to this organization in the NPPES registry on April 12, 2018. The provider is doing business as Utica Park Clinic Primary Care.

Q: What is Ahs Henryetta Hospital LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Active since April 12, 2018CLIA 37D2053123 · Waiver

2405 W MAIN ST STE A, HENRYETTA, OK 74437(918) 650-1180(918) 650-1294 Get Directions Write a Review

NPPES record last updated: May 29, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 29, 2019, Nov 7, 2018, Jul 27, 2018 and 2 more (5 updates tracked since 2018).

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About Utica Park Clinic Primary Care NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

UTICA PARK CLINIC PRIMARY CARE (NPI 1295232478) is a healthcare organization registered as a rural health in Henryetta, Oklahoma and active in the NPI registry since April 2018. The organization holds a CLIA Waiver certificate valid through January 24, 2027 and lists Stephen C. Petrovich, Evp, as its authorized official.

NPPES Registry Identity

NPI1295232478

Entity TypeOrganization

Primary Taxonomy261QR1300X

Legal Business NameAHS HENRYETTA HOSPITAL LLC

Location Address2405 W MAIN ST STE AHenryetta, OK 74437

Mailing Address2405 W Main StHenryetta, OK 74437-3893 · (918) 650-1180 · Fax (918) 650-1294

Phone(918) 650-1180

Fax(918) 650-1294

Organization SubpartYesParent: Ahs Hillcrest Healthcare System, Llc

Authorized OfficialStephen C. PetrovichEvp · (615) 296-3000

Enumeration DateApril 12, 2018

Last NPPES UpdateMay 29, 20195 updates tracked since enumeration

✔ NPI 1295232478 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities

Taxonomy Code261QR1300X

Also ListedClinic/CenterTaxonomy 261Q00000X

2405 W MAIN ST STE A, Henryetta, OK 74437

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Other Names 1

Doing Business AsUtica Park Clinic Primary Care

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 37D2053123

Utica Park Clinic Primary Care · Henryetta, OK

Active · expires Jan 24, 2027

CLIA Number37D2053123

Laboratory TypePhysician Office

Certificate Effective DateJanuary 25, 2025

Certificate Expiration DateJanuary 24, 2027

Laboratory DirectorEris Mathis

Laboratory Phone(918) 650-1180

Laboratory LocationUtica Park Clinic Primary Care2405 W Main St, Suite A, Henryetta, OK 74437

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ahs Henryetta Hospital LLC's NPI number?

The NPI number for Ahs Henryetta Hospital LLC is 1295232478. It was assigned to this organization in the NPPES registry on April 12, 2018. The provider is doing business as Utica Park Clinic Primary Care.

Where is Ahs Henryetta Hospital LLC located?

Ahs Henryetta Hospital LLC is located at 2405 W Main St Ste A, Henryetta, OK 74437. The listed phone number is (918) 650-1180.

What is Ahs Henryetta Hospital LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Ahs Henryetta Hospital LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 37D2053123) is associated with this NPI, valid through January 24, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Ahs Henryetta Hospital LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Ahs Henryetta Hospital LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ahs Henryetta Hospital LLC was last updated on May 29, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.