NORTHEASTERN OKLAHOMA COMMUNITY HEALTH CENTERS, INC. (NPI# 1073164125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073164125 |
| Entity Type | Organization |
| Organization Name | NORTHEASTERN OKLAHOMA COMMUNITY HEALTH CENTERS, INC. |
| Other Organization Name | TAHLEQUAH ENT |
| Practice Address |
1203 E Ross Byp Tahlequah OK 74464-4133 |
| Mailing Address |
Po Box 751 Hulbert OK 74441-0751 |
| Practice Telephone | 9184539002 |
| Practice Fax Number | 9184530328 |
| Mailing Telephone | 9187723390 |
| Mailing Fax Number | 9187722244 |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2020-06-09 |
| Authorized Official Name | SCOTT ROSENTHAL (CEO) |
| Authorized Official Telephone | 9187723390 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Tahlequah ENT | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144777319 | Northeastern Oklahoma Community Health Centers, Inc. | Clinic/Center | 529 N. Oak St., Tahlequah, OK 74464 | 2016-09-06 |
| 1972052983 | Northeastern Oklahoma Community Health Centers, Inc. | Clinic/Center | 1500 E Downing St, Suite 101, Tahlequah, OK 74464-3234 | 2016-10-03 |
| 1609254507 | Northeastern Oklahoma Community Health Centers, Inc. | Clinic/Center | 101 E Ferry St, Salina, OK 74365-2988 | 2015-05-12 |
| 1447658711 | Northeastern Oklahoma Community Health Centers, Inc. | Clinic/Center | 1201 W 4th St, Tahlequah, OK 74464-5091 | 2014-12-18 |
| Street Address |
1203 E ROSS BYP |
| City | TAHLEQUAH |
| State | OK |
| Zip Code | 74464-4133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700875598 | Lori Lyn Enlow | Nurse Practitioner | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464 | 2005-10-14 |
| 1023311438 | Osu Center for Health Sciences | Clinic/Center | 1203 E Ross Byp, Suite 1a, Tahlequah, OK 74464-4133 | 2010-12-08 |
| 1649584855 | Lea Sarah Humphrey | Otolaryngology | 1203 E Ross Byp, Tahlequah, OK 74464-4133 | 2010-07-29 |
| 1316258619 | Osu Center for Health Sciences | Clinic/Center | 1203 E Ross Byp, Tahlequah, OK 74464-4133 | 2010-07-01 |
| 1659568301 | Cmg Family Clinic LLC | Family Medicine | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4133 | 2007-09-26 |
| 1720274699 | Tracey W. Childers, D.o. P.C. | Otolaryngology | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4188 | 2007-09-24 |
| 1730227299 | Philip Dean Watson | Physician Assistant | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4133 | 2007-02-04 |
| 1568412310 | Susan K Anderson | Otolaryngology | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4133 | 2006-05-11 |
| 1053371021 | Tracey Way Childers | Otolaryngology | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4188 | 2006-03-24 |
| 1114909843 | Andrea D Mitchell | Physician Assistant | 1203 E Ross Byp, Suite A, Tahlequah, OK 74464-4133 | 2005-11-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184253403 | Kendall Harris | Student in an Organized Health Care Education/Training Program | 100 Bliss Ave, Tahlequah, OK 74464 | 2020-04-07 |
| 1528609302 | Norma Brightly | Technician | 103 Sequoyah, Tahlequah, OK 74464 | 2019-10-03 |
| 1073175832 | Jody Lynn Dallis | Case Manager/Care Coordinator | Tenkiller Behavioral Services, 27753 S. Welling Rd, Welling, OK 74464 | 2019-07-02 |
| 1184287849 | Perry Jake Proctor | Student in an Organized Health Care Education/Training Program | 1400 E Downing St, Tahlequah, Ok 74464, Tahlequah, OK 74464 | 2019-04-18 |
| 1336657279 | Sidney Sheyenne Kimble | Case Manager/Care Coordinator | 1429 Jack Brown Lane, Tahlequah, OK 74464 | 2018-01-12 |
| 1891225686 | Nichols Bradley Alberty | Orthotist | 1294 East Downing, Suite 3, Tahlequah, OK 74464 | 2017-06-14 |
| 1922549690 | Krystal Easter Ms, Lpc | Counselor | 2201 Oakridge Dr, Tahlequah, OK 74464 | 2017-03-15 |
| 1144777319 | Northeastern Oklahoma Community Health Centers, Inc. | Clinic/Center | 529 N. Oak St., Tahlequah, OK 74464 | 2016-09-06 |
| 1548713456 | Clement Isioma Nwadozi | Optometrist | 3763 Southridge Cir Apt 6, Tahlequah, OK 74464 | 2016-07-27 |
| 1033532635 | Wesley Gragg | Specialist/Technologist | 603 North Grand Avenue, Tahlequah, OK 74464 | 2014-02-03 |
| Find all providers in zip 74464 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144777319 | Northeastern Oklahoma Community Health Centers, Inc. | Clinic/Center | 529 N. Oak St., Tahlequah, OK 74464 | 2016-09-06 |
| 1376513002 | Northeastern Oklahoma Community Health Centers Inc | Clinic/Center | 1310 E Boone St, Tahlequah, OK 74464-3338 | 2006-01-25 |
| 1972052983 | Northeastern Oklahoma Community Health Centers, Inc. | Clinic/Center | 1500 E Downing St, Suite 101, Tahlequah, OK 74464-3234 | 2016-10-03 |
| 1447658711 | Northeastern Oklahoma Community Health Centers, Inc. | Clinic/Center | 1201 W 4th St, Tahlequah, OK 74464-5091 | 2014-12-18 |
| 1366744534 | Northeastern Oklahoma Community Health Centers, Inc | Clinic/Center | 1500 E Downing St, Suite 214, Tahlequah, OK 74464-3379 | 2010-11-22 |
| 1184926362 | Northeastern Oklahoma Community Health Centers, Inc | Clinic/Center | 1500 E Downing St, Suite 208, Tahlequah, OK 74464-3234 | 2010-11-22 |
| 1891097077 | Northeastern Oklahoma Community Health Centers, Inc | Clinic/Center | 1500 E Downing St Ste 102, Tahlequah, OK 74464-3354 | 2010-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902404965 | Variety Care, Inc. | Clinic/Center | 201 Ne 50th St Ste 117, Oklahoma City, OK 73105-1811 | 2020-10-13 |
| 1699318550 | Community Health Center of Northeast Oklahoma, Inc. | Clinic/Center | 220 S Mickey Mantle Blvd, Commerce, OK 74339-2924 | 2019-10-23 |
| 1013567940 | Community Health Center of Southeast Kansas, Inc. | Clinic/Center | 7 S 1st St, Wyandotte, OK 74370-2268 | 2019-09-12 |
| 1013569961 | Community Health Connection, Inc. | Clinic/Center | 13702 E 46th Pl, Tulsa, OK 74134-5919 | 2019-07-11 |
| 1184286726 | Central Oklahoma Family Medical Center, Inc | Clinic/Center | 302 W Smith Street, Stratford, OK 74872-4648 | 2019-07-03 |
| 1982263752 | Shortgrass Community Health Center, Inc | Clinic/Center | 211 East Broadway, Altus, OK 73521 | 2019-06-06 |
| 1265902589 | Community Health Center of Northeast Oklahoma | Clinic/Center | 244 S Scraper Suite D, Vinita, OK 74301-3716 | 2018-11-29 |
| 1063988673 | Central Oklahoma Family Medical Center, Inc | Clinic/Center | 905 Colony Drive Bldg, Ada, OK 74820 | 2018-10-22 |
| 1306352547 | Variety Care, Inc. | Clinic/Center | 721 W Britton Rd, Oklahoma City, OK 73114-2909 | 2017-12-26 |
| 1568976991 | Arkansas Verdigris Valley Health Centers,inc. | Clinic/Center | 201 North 32nd Street, Muskogee, OK 74401-2104 | 2017-11-21 |
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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.