CITIZEN POTAWATOMI NATION (NPI# 1689680670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689680670 |
| Entity Type | Organization |
| Organization Name | CITIZEN POTAWATOMI NATION |
| Other Organization Name | CITIZEN POTAWATOMI NATION CLINIC PHARMACY |
| Practice Address |
2307 S Gordon Cooper Dr Shawnee OK 74801-9007 |
| Practice Telephone | 4052735236 |
| Practice Fax Number | 4052732392 |
| Mailing Telephone | 4052735236 |
| Mailing Fax Number | 4052732392 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JOHN JOSEPH LAREAU (PHARMACY COORDINATOR) |
| Authorized Official Telephone | 4052735236 |
| Authorized Official Credential | DPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 10-4078 | OK | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| citizen potawatomi nation clinic pharmacy | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427659523 | Citizen Potawatomi Nation | Chiropractor | 204 E Walnut St, Tecumseh, OK 74873-2030 | 2020-11-04 |
| 1881981744 | Citizen Potawatomi Nation | Clinic/Center | 781 Grand Casino Blvd, Shawnee, OK 74804-1005 | 2011-06-29 |
| 1194752949 | Citizen Potawatomi Nation | Clinic/Center | 2307 S Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2006-06-27 |
| Street Address |
2307 S GORDON COOPER DR |
| City | SHAWNEE |
| State | OK |
| Zip Code | 74801-9007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871571901 | Carrie Ann Wood | Internal Medicine | 2307 S Gordon Cooper Dr, Shawnee, OK 74801 | 2006-01-09 |
| 1952678518 | Dana Marie Kelley | Licensed Practical Nurse | 2307 S Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2011-11-28 |
| 1326348095 | Tina Louise Ferguson | Licensed Practical Nurse | 2307 S Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2010-10-28 |
| 1528375359 | Betty Jane Nicholson | Registered Nurse | 2307 S Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2010-08-31 |
| 1669786208 | Latisha Lynn Bader | Psychologist | 2307 S Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2010-08-05 |
| 1598954695 | Christia Ann Hallinan | Licensed Practical Nurse | 2307 S Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2007-10-15 |
| 1932396470 | Lielani M Tull | Clinic/Center | 2307 S Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2007-09-28 |
| 1962699884 | Samantha Rae Manion | Licensed Practical Nurse | 2307 S Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2007-09-25 |
| 1952597833 | Amanda Kaylene Felkner | Clinic/Center | 2307 S Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2007-09-24 |
| 1104012301 | Aubre Ann Reed | Clinic/Center | 2307 S Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2007-09-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538609037 | Melissa Lanier | Specialist | 801 N. Louisa, Shawnee, OK 74801 | 2017-03-02 |
| 1518365287 | Melanie A. Croy | Counselor | 1605 N. Harrison, Shawnee, OK 74801 | 2014-12-12 |
| 1134532229 | Megan Malouf | Registered Nurse | 2307 Gordon Cooper Dr., Shawnee, OK 74801 | 2014-06-05 |
| 1063836609 | Daniel Antwain Shaw | Counselor | 605 S. Pottenger Ave, Shawnee, OK 74801 | 2014-02-18 |
| 1639514862 | Cheryl Jeannette Left Hand | Counselor | 101 N. Union, Shawnee, OK 74801 | 2013-05-01 |
| 1881948644 | Lena I Samilton | Counselor | 319 S. Kennedy Ave., Apt.112, Shawnee, OK 74801 | 2012-11-01 |
| 1235433681 | Jenifer Sloan | Case Manager/Care Coordinator | 2029 S. Gordon Cooper Dr., Shawnee, OK 74801 | 2010-12-28 |
| 1295854958 | Jack C Luman | Dentist | 1410 N Harrison St, Shawnee, OK 74801 | 2007-03-27 |
| 1942375274 | M Gerald Ball | Psychologist | 819 North Kickapoo, Shawnee, OK 74801 | 2006-11-21 |
| 1205912573 | Regina Steciak Tanner | Physical Therapist | 909 N Kickapoo, Shawnee, OK 74801 | 2006-10-31 |
| Find all providers in zip 74801 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326557158 | Lumen Care Center, LLC | Clinic/Center | 6800 Hilltop Rd Ste 101, Shawnee, KS 66226-3571 | 2017-09-25 |
| 1649755158 | Oklahoma Mental Health Council | Clinic/Center | 101 N Union Ave, Shawnee, OK 74801-7067 | 2018-10-01 |
| 1396220844 | Oklahoma Mental Health Council | Clinic/Center | 101 N Union Ave, Shawnee, OK 74801-7067 | 2018-10-01 |
| 1144702366 | Chiropractic Pain Clinic | Clinic/Center | 16314 W 65th St, Shawnee, KS 66217-9799 | 2018-09-04 |
| 1639534332 | Sweet Sleep Studio, LLC | Clinic/Center | 7410 Switzer St, Shawnee, KS 66203-4550 | 2015-12-22 |
| 1598034993 | Star Chiropractic Family Clinic | Clinic/Center | 11644 W 75th St, Suite 102, Shawnee, KS 66214-1372 | 2011-12-14 |
| 1063701985 | Midwives of Kansas City, LLC | Clinic/Center | 6115 Nieman Rd, Shawnee, KS 66203-2939 | 2011-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275471 | Osu Center for Health Sciences | Clinic/Center | 1 E Clark Bass Blvd Ste 201, Mcalester, OK 74501-4209 | 2020-11-06 |
| 1427662170 | Osu Center for Health Sciences | Clinic/Center | 802 S Jackson Ave Ste 410, Tulsa, OK 74127-9059 | 2020-09-01 |
| 1154949642 | Osu Center for Health Sciences | Clinic/Center | 140 W 151st St S, Glenpool, OK 74033-4523 | 2020-07-10 |
| 1235757071 | Equality Health Group LLC | Clinic/Center | 4301 Nw 63rd St Ste 109, Oklahoma City, OK 73116-1548 | 2020-07-08 |
| 1538785985 | Stars and Stripes Therapy Inc. | Clinic/Center | 713 Sw C Ave Ste A, Lawton, OK 73501-4311 | 2020-06-22 |
| 1265058101 | Taylor Medical Group, LLP | Clinic/Center | 735 W Locust St, Stilwell, OK 74960-3403 | 2020-06-16 |
| 1891317731 | Sparks Medical Consulting LLC | Clinic/Center | 1604 Sw 38th St, Moore, OK 73160-2953 | 2020-05-14 |
| 1093341844 | Osu Center for Health Sciences | Clinic/Center | 3201 W Gore Blvd Ste G2, Lawton, OK 73505-6323 | 2020-03-12 |
| 1255964128 | Osu Center for Health Sciences | Clinic/Center | 110 Nw 31st St Fl 3, Lawton, OK 73505-6100 | 2020-02-19 |
| 1104458231 | Osu Center for Health Sciences | Clinic/Center | 6501 S Western Ave Ste 101, Oklahoma City, OK 73139-1709 | 2020-02-06 |
| Find all providers with the same taxonomy | ||||
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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.