CHOCTAW NATION OF OKLAHOMA (NPI# 1710953799) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710953799 |
| Entity Type | Organization |
| Organization Name | CHOCTAW NATION OF OKLAHOMA |
| Other Organization Name | CHOCTAW NATION HEALTH CARE CLINIC-POTEAU |
| Practice Address |
109 Kerr Ave Poteau OK 74953-5231 |
| 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 | 2012-01-26 |
| Authorized Official Name | MRS. TERESA KAY JACKSON (ADMINISTRATOR) |
| 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 | 100699600G | 05 |
| Other Name | Type Code |
|---|---|
| Choctaw Nation Health Care Clinic-Poteau | 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 |
109 KERR AVE |
| City | POTEAU |
| State | OK |
| Zip Code | 74953-5231 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134105059 | Frank Jay Smith | Physician Assistant | 109 Kerr Ave, Poteau, OK 74953-5270 | 2005-12-22 |
| 1134690944 | Crystal D Hensley | Registered Nurse | 109 Kerr Ave, Poteau, OK 74953-5270 | 2018-12-06 |
| 1174004139 | Alex Nevitt | Physical Therapist | 109 Kerr Ave, Poteau, OK 74953-5270 | 2018-08-27 |
| 1780136705 | Choctaw Nation Health Services Authority | Clinic/Center | 109 Kerr Ave, Poteau, OK 74953-5270 | 2016-10-25 |
| 1316493380 | Megan Schmidt | Pharmacist | 109 Kerr Ave, Poteau, OK 74953-5270 | 2016-08-30 |
| 1669838983 | Michelle Rene Dawson | Physician Assistant | 109 Kerr Ave, Poteau, OK 74953-5270 | 2016-01-04 |
| 1578938064 | Jammie Owens | Pharmacist | 109 Kerr Ave, Poteau, OK 74953-5270 | 2015-12-09 |
| 1457734063 | Jennifer Dillard | Optometrist | 109 Kerr Ave, Poteau, OK 74953-5270 | 2015-06-30 |
| 1063847556 | Stefanie Janine Terrell | Pharmacist | 109 Kerr Ave, Poteau, OK 74953 | 2013-09-04 |
| 1841549318 | Jessica Lois Hall | Physician Assistant | 109 Kerr Ave, Poteau, OK 74953-5270 | 2012-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235644550 | Kim Lynn Mcconnell | Case Manager/Care Coordinator | 907 Grace St., Poteau, OK 74953 | 2017-12-08 |
| 1356889745 | Brenda Stacy | Prevention Professional | 507 Drwey, Potesu, OK 74953 | 2017-02-06 |
| 1639621451 | Sabrina Danielle Minor | Case Manager/Care Coordinator | 15715 Greentop Road, Poteau, OK 74953 | 2016-10-27 |
| 1902352545 | Daniel Jesse Bruesch | Counselor | 600 Oklahoma Ave., Poteau, OK 74953 | 2016-09-01 |
| 1578912465 | Jo Ann Walden | Counselor | 507 Dewey Avenue, Poteau, OK 74953 | 2016-06-10 |
| 1154708477 | Kendal Repass | Specialist/Technologist | 17100 Nail Creek, Poteau, OK 74953 | 2015-05-06 |
| 1669891768 | Jennifer Branscum | Case Manager/Care Coordinator | 22681 Valley View Rd, Poteau, OK 74953 | 2014-04-16 |
| 1437582145 | Kim Loggains | Counselor | 2104 A-n. Broadway, Poteau, OK 74953 | 2013-08-16 |
| 1457783573 | Derek Morris | Counselor | 3111b N. Broadway St., Box 34, Poteau, OK 74953 | 2013-07-31 |
| 1568743177 | Carol Ann Oliver | Counselor | 34183 Country Club Lane, Poteau, OK 74953 | 2011-09-09 |
| Find all providers in zip 74953 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659892115 | Henri Bienvenido Ramirez Mendez | Clinic/Center | 500 S Broadway St Ste B, Poteau, OK 74953-3819 | 2017-07-05 |
| 1265887616 | Gtz and Enk | Clinic/Center | 2706 N Broadway St, Poteau, OK 74953-5402 | 2016-05-03 |
| 1538566286 | Hometown Drug Company LLC | Clinic/Center | 307 N Broadway St, Poteau, OK 74953-3355 | 2014-11-24 |
| 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.