CHOCTAW NATION OF OKLAHOMA (NPI# 1407822497) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407822497 |
| Entity Type | Organization |
| Organization Name | CHOCTAW NATION OF OKLAHOMA |
| Other Organization Name | CHOCTAW NATION HEALTH CLINIC-IDABEL |
| Practice Address |
902 E Lincoln Rd Idabel OK 74745-7337 |
| Mailing Address |
1 Choctaw Way Talihina OK 74571-2022 |
| Practice Telephone | 9185677000 |
| Practice Fax Number | 9185677041 |
| Mailing Telephone | 9185677000 |
| Mailing Fax Number | 9185677041 |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2008-01-24 |
| Authorized Official Name | MS. TERESA KAY JACKSON (ADMINISTRATOAR) |
| 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 |
| Other Name | Type Code |
|---|---|
| Choctaw Nation Health Clinic-Idabel | 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 |
| 1396173449 | Choctaw Nation of Oklahoma | Clinic/Center | 1801 Chukka Hina, Durant, OK 74701-3085 | 2013-10-29 |
| 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 |
| 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 |
902 E LINCOLN RD |
| City | IDABEL |
| State | OK |
| Zip Code | 74745-7337 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821083783 | Dana Renee Evans | Pharmacist | 902 E Lincoln Rd, Idabel, OK 74745-7337 | 2005-09-16 |
| 1922570480 | Charity Stafford | Speech-Language Pathologist | 902 E Lincoln Rd, Idabel, OK 74745-7337 | 2018-12-21 |
| 1528538329 | Annette Ledawn Choate | Registered Nurse | 902 E Lincoln Rd, Idabel, OK 74745-7337 | 2018-12-05 |
| 1386114999 | Melody Dedmon | Dietitian, Registered | 902 E Lincoln Rd, Idabel, OK 74745-7337 | 2018-11-27 |
| 1659818110 | Rachel Dollarhide | Physician Assistant | 902 E Lincoln Rd, Idabel, OK 74745-7337 | 2017-01-23 |
| 1528511763 | Kimberly Gaines | Pharmacist | 902 E Lincoln Rd, Idabel, OK 74745-7337 | 2016-07-24 |
| 1346628088 | Dwala Gibson | Nurse Practitioner | 902 E Lincoln Rd, Idabel, OK 74745-7337 | 2015-05-14 |
| 1417359233 | Lindsey Timbes | Pharmacist | 902 E Lincoln Rd, Idabel, OK 74745-7337 | 2014-09-24 |
| 1356777999 | Antonio Cuasay Ambas Jr. | Dentist | 902 E Lincoln Rd, Idabel, OK 74745-7337 | 2013-09-14 |
| 1255764387 | Joshua M Golden | Optometrist | 902 E Lincoln Rd, Idabel, OK 74745-7337 | 2013-08-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568957348 | Home Run Healthcare | Family Medicine | 1425 East Lincoln Road, Suite A-3, Idabel, OK 74745 | 2018-06-25 |
| 1720457203 | Leann Tomlinson | Registered Nurse | 2002 E Lincoln Rd, Idabel, OK 74745 | 2015-09-15 |
| 1659795508 | Laura Rush | Optometrist | 902 Lincoln Road, Idabel, OK 74745 | 2014-02-13 |
| 1619301116 | White River Home Health | Home Health | 2100 East Washington Street Ste D, Idabel, OK 74745 | 2013-09-03 |
| 1922440999 | John Phillip Stone Scoggin | Counselor | 111 Canterbury Lane, Idabel, OK 74745 | 2013-07-19 |
| 1841576725 | Ayesha Shante Wyatt | Nurse's Aide | 1800 Hillcrest, Idabel, OK 74745 | 2011-10-24 |
| 1154569457 | Southern Oklahoma Treatment Services, Inc. | Community/Behavioral Health | 6 Southeast Avenue A, Idabel, OK 74745 | 2009-01-26 |
| 1417103854 | John Hoskins | Internal Medicine | 902 Lincoln Rd, Choctaw Nation Health Clinic, Idabel, OK 74745 | 2008-08-18 |
| 1801077045 | Rhonda Cheryl Rodgers | Counselor | 104 Ne Ave A, Idabel, OK 74745 | 2007-11-15 |
| 1326241548 | Beverly Gayle Jasper-hayes | Counselor | 104 Ne A - Avenue, Idabel, OK 74745 | 2007-06-06 |
| Find all providers in zip 74745 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841740735 | Stathealth Clinic | Clinic/Center | 1254 S Lynn Ln, Idabel, OK 74745-6813 | 2016-10-04 |
| 1912298845 | Stathealth Clinic Pllc | Clinic/Center | 805 Se Washington St, Idabel, OK 74745-3331 | 2011-04-26 |
| 1689985343 | Idabel Children's Clinic, Inc. | Clinic/Center | 1307 Lynn Ln, Idabel, OK 74745-6845 | 2010-06-28 |
| 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.