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STILLWATER MEDICAL CENTER AUTHORITY
NPI 1558990192
Clinic/Center - Rural Health in Blackwell, OK

Active since April 06, 2020
706 S 13TH ST STE C, BLACKWELL, OK 74631(580) 363-9354 Get Directions Write a Review

NPPES record last updated: April 6, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Stillwater Medical Center Authority NPPES

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

STILLWATER MEDICAL CENTER AUTHORITY (NPI 1558990192), doing business as Blackwell Primary Care, is a healthcare organization registered as a rural health in Blackwell, Oklahoma and active in the NPI registry since April 2020. The organization lists Denise Adrienne Webber, Ceo, as its authorized official.

NPPES Registry Identity

NPI1558990192
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameSTILLWATER MEDICAL CENTER AUTHORITY
Location Address706 S 13TH ST STE CBlackwell, OK 74631-3705
Mailing AddressPo Box 720006Norman, OK 73070-4006 · (405) 742-5300
Phone(580) 363-9354
Organization SubpartNo
Authorized OfficialDenise Adrienne WebberCeo · (405) 742-5230
Enumeration DateApril 6, 2020
NPPES CertifiedApril 6, 2020
✔ NPI 1558990192 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
706 S 13TH ST STE C, Blackwell, OK 74631
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Other Names 1

Doing Business AsBlackwell Primary Care

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stillwater Medical Center Authority is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateOklahomaEnrollment IDO20201210001849Part A · Rural Health ClinicDue dateFebruary 28, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BLACKWELL HOSPITAL TRUST AUTHORITY
Clinic/Center (Rural Health)
706 S 13TH ST STE C
BLACKWELL, OK 74631
Kay County (580) 363-2311
BLACKWELL HOSPITAL TRUST AUTHORITY
Internal Medicine
706 S 13TH ST STE C
BLACKWELL, OK 74631
Kay County (580) 363-2311

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 Stillwater Medical Center Authority's NPI number?

The NPI number for Stillwater Medical Center Authority is 1558990192. It was assigned to this organization in the NPPES registry on April 6, 2020. The provider is doing business as Blackwell Primary Care.

Where is Stillwater Medical Center Authority located?

Stillwater Medical Center Authority is located at 706 S 13th St Ste C, Blackwell, OK 74631. The listed phone number is (580) 363-9354.

What is Stillwater Medical Center Authority's specialty?

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

Is Stillwater Medical Center Authority enrolled in Medicare?

Yes. Stillwater Medical Center Authority is registered in the Medicare PECOS enrollment system.

When is Stillwater Medical Center Authority's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Part A enrollment for this organization (Oklahoma, Rural Health Clinic) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

When was this NPI record last updated?

The NPPES record for Stillwater Medical Center Authority was last updated on April 6, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.