CHOCTAW NATION OF OKLAHOMA (NPI# 1396173449) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396173449 |
| Entity Type | Organization |
| Organization Name | CHOCTAW NATION OF OKLAHOMA |
| Other Organization Name | CHOCTAW NATION HEALTH CARE CLINIC - DURANT |
| Practice Address |
1801 Chukka Hina Durant OK 74701-3085 |
| Practice Telephone | 5809202100 |
| Practice Fax Number | 5809247215 |
| Mailing Telephone | 5809202100 |
| Mailing Fax Number | 5809247215 |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2017-01-23 |
| Authorized Official Name | MRS. TERESA KAY JACKSON (CEO) |
| Authorized Official Telephone | 9185677000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | MEDICARE | 370172 | 01 |
| OK | 100244980T | 05 |
| Other Name | Type Code |
|---|---|
| Choctaw Nation Health Care Clinic - Durant | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982992269 | Choctaw Nation of Oklahoma | Clinic/Center | 205 Dallas St, Talihina, OK 74571-2402 | 2011-07-20 |
| 1902078728 | Choctaw Nation of Oklahoma | Clinic/Center | 1201 W Liberty Rd, Atoka, OK 74525-1639 | 2008-04-01 |
| 1174599088 | Choctaw Nation of Oklahoma | Clinic/Center | 410 North M, Hugo, OK 74743 | 2006-02-28 |
| 1770559619 | Choctaw Nation of Oklahoma | Clinic/Center | 205 E 3rd St, Broken Bow, OK 74728-4119 | 2006-02-28 |
| 1104344027 | Choctaw Nation of Oklahoma | Clinic/Center | 1 Choctaw Way, Talihina, OK 74571-2022 | 2017-08-30 |
| 1306384821 | Choctaw Nation of Oklahoma | Clinic/Center | 1801 Chukka Hina, Durant, OK 74701-3085 | 2017-02-03 |
| 1295142115 | Choctaw Nation of Oklahoma | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1801 Chukka Hina, Durant, OK 74701 | 2014-07-14 |
| 1659674455 | Choctaw Nation of Oklahoma | General Acute Care Hospital | 1 Choctaw Way, Talihina, OK 74571-2022 | 2010-12-16 |
| 1790833564 | Choctaw Nation of Oklahoma | Clinic/Center | 902 E Lincoln Rd, Idabel, OK 74745-7337 | 2007-01-08 |
| 1609924471 | Choctaw Nation of Oklahoma | Clinic/Center | 2204 E Main St, Stigler, OK 74462-2822 | 2007-01-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CHOCTAW NATION OF OKLAHOMA | 1802 Chukka Hina, Durant, OK 74701-7117 |
| Street Address |
1801 CHUKKA HINA |
| City | DURANT |
| State | OK |
| Zip Code | 74701-3085 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558574574 | Michael H Arredondo | Internal Medicine | 1801 Chukka Hina, Durant, OK 74701-7117 | 2007-05-07 |
| 1811544307 | Ashley Morgan | Dietitian, Registered | 1801 Chukka Hina, Durant, OK 74701-7117 | 2019-08-20 |
| 1265085013 | Garrison Smith Lorey Sr. | Pulmonary Function Technologist | 1801 Chukka Hina, Durant, OK 74701-7117 | 2019-07-22 |
| 1356810808 | Cynthia Bernice Williams | Registered Nurse | 1801 Chukka Hina, Durant, OK 74701-7117 | 2018-11-14 |
| 1003399940 | Haley Harrison | Nurse Practitioner | 1801 Chukka Hina, Durant, OK 74701-7117 | 2018-09-06 |
| 1871097741 | Bobby Don Priddy Jr. | Nurse Practitioner | 1801 Chukka Hina, Durant, OK 74701 | 2018-03-23 |
| 1053824359 | Darci Lynn Bowen | Nurse Practitioner | 1801 Chukka Hina, Durant, OK 74701 | 2017-11-08 |
| 1306384821 | Choctaw Nation of Oklahoma | Clinic/Center | 1801 Chukka Hina, Durant, OK 74701-3085 | 2017-02-03 |
| 1235587627 | Quinton Tieu | Family Medicine | 1801 Chukka Hina, Durant, OK 74701-7117 | 2016-05-26 |
| 1295142115 | Choctaw Nation of Oklahoma | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1801 Chukka Hina, Durant, OK 74701 | 2014-07-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134738362 | Elevate Therapy, Pllc | Physical Therapist | 523 N Wshington Ave, Durant, OK 74701 | 2020-07-23 |
| 1093334906 | Duncan Kovash | Nurse Practitioner | 1901 Chukka Hina, Durant, OK 74701 | 2020-04-10 |
| 1184193690 | Inventive Therapy Services, LLC | Occupational Therapist | 2620 Maxey Dr, Durant, OK 74701 | 2018-11-14 |
| 1790271831 | Jazmine Gabrielle Benavidez | Specialist/Technologist | 1713 North 1st Avenue, Durant, OK 74701 | 2018-07-02 |
| 1538659586 | Katelen Sue Morgan | Case Manager/Care Coordinator | 1011 Donna Sue Pl, Durant, OK 74701 | 2018-05-15 |
| 1164941035 | Nsight for Life LLC | Community/Behavioral Health | 1313 N 16th, Durant, OK 74701 | 2017-09-12 |
| 1023534666 | Damon Dye | Physical Therapist | 30 W 3rd St, Durant, OK 74701 | 2017-08-15 |
| 1437605250 | Casey Worsham | Nurse Practitioner | 1800 W University, Durant, OK 74701 | 2016-08-31 |
| 1083160857 | Denise Adanho | Case Manager/Care Coordinator | 1218 Stonebrook Circle, Durant, OK 74701 | 2016-08-31 |
| 1962850271 | Justi Thompson | Case Manager/Care Coordinator | 4817 Ciara St, Durant, OK 74701 | 2016-05-26 |
| Find all providers in zip 74701 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912433459 | S&m Medical Clinic | Clinic/Center | 403 Northwest Depot Street, Durant, MS 39063 | 2017-05-03 |
| 1124100813 | Durant Primary Care Clinic | Clinic/Center | 638 Northwest Ave, Durant, MS 39063-3337 | 2006-10-20 |
| 1063849578 | Glover Primary Care Clinic | Clinic/Center | 403 Nw Depot St, Durant, MS 39063-3705 | 2013-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609476654 | Team Clinic Management Partners LLC | Clinic/Center | 372 N Cobb, Caney, OK 74533 | 2020-10-29 |
| 1184222705 | Essential Md, Pllc | Clinic/Center | 6316 E 102nd St Ste 100, Tulsa, OK 74137-7061 | 2020-10-15 |
| 1881292191 | Team Clinic Management Partners LLC | Clinic/Center | 3100 W New Orleans St, Broken Arrow, OK 74011-1468 | 2020-10-09 |
| 1972115392 | Team Clinic Management Partners LLC | Clinic/Center | 225 E Omaha St, Broken Arrow, OK 74012-1761 | 2020-08-18 |
| 1093327413 | Team Clinic Management Partners LLC | Clinic/Center | 301 W New Orleans St, Broken Arrow, OK 74011-2206 | 2020-08-18 |
| 1962013110 | Team Clinic Management Partners LLC | Clinic/Center | 4300 E Gary Street, Broken Arrow, OK 74014 | 2020-08-12 |
| 1750992038 | Team Clinic Management Partners LLC | Clinic/Center | 251 E Omaha St, Broken Arrow, OK 74012-1761 | 2020-08-11 |
| 1689285975 | Team Clinic Management Partners LLC | Clinic/Center | 301 E Tucson St, Broken Arrow, OK 74011-7235 | 2020-08-11 |
| 1417568700 | Team Clinic Management Partners LLC | Clinic/Center | 1351 E Albany St, Broken Arrow, OK 74012-8995 | 2020-08-11 |
| 1164033569 | Team Clinic Management Partners LLC | Clinic/Center | 6800 E Quincy Pl, Broken Arrow, OK 74014-4523 | 2020-08-11 |
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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.