CHOCTAW NATION OF OKLAHOMA (NPI# 1770559619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770559619 |
| Entity Type | Organization |
| Organization Name | CHOCTAW NATION OF OKLAHOMA |
| Other Organization Name | CHOCTAW NATION HEALTH CLINIC-BROKEN BOW |
| Practice Address |
205 E 3rd St Broken Bow OK 74728-4119 |
| 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 | 2008-01-28 |
| 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 |
| Other Name | Type Code |
|---|---|
| Choctaw Nation Health Clinic-Broken Bow | 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 |
| 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 |
| 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 |
205 E 3RD ST |
| City | BROKEN BOW |
| State | OK |
| Zip Code | 74728-4119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992962716 | Judy Ann Brown | Counselor | 205 E 3rd St, Broken Bow, OK 74728-4119 | 2008-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730732926 | Natorrie D'atra Morris | Nurse Practitioner | Mccurtain Family Medical Clinic, 800 N Park Dr, Broken Bow, OK 74728 | 2019-07-17 |
| 1477925535 | Rebecca Stover | Nurse Practitioner | 813 Veterans Way, Broken Bow, OK 74728 | 2015-10-28 |
| 1023366614 | Tlc Family Clinic, LLC | Clinic/Center | 700 W. Jones, Tlc Family Clinic, LLC, Broken Bow, OK 74728 | 2012-08-29 |
| 1699925867 | Faith Lucille Phillips | Psychologist | 411 S. Park Drive, Broken Bow, OK 74728 | 2008-09-24 |
| 1265057251 | Heather Renee Payne | Counselor | 205 N. Main St, Broken Bow, OK 74728 | 2020-06-15 |
| 1396244109 | Erika Ann White | Counselor | 205 N Main St, Broken Bow, OK 74728 | 2018-02-07 |
| 1366954661 | Black Oak Clinic LLC | Clinic/Center | 110 W 1st St, Broken Bow, OK 74728 | 2017-10-26 |
| 1922467505 | Stover Family Clinic | Clinic/Center | 813 Veterans Way, Broken Bow, OK 74728 | 2016-02-11 |
| 1568820140 | Megan Elizabeth Black | Nurse Practitioner | 110 W 1st St, Broken Bow, OK 74728 | 2016-02-10 |
| 1578797221 | Kenneth G Ericksen | Chiropractor | 1605 S Park Dr, Broken Bow, OK 74728 | 2009-05-11 |
| Find all providers in zip 74728 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023366614 | Tlc Family Clinic, LLC | Clinic/Center | 700 W. Jones, Tlc Family Clinic, LLC, Broken Bow, OK 74728 | 2012-08-29 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | BROKEN BOW |
| Zip Code | 74728 |
Please comment or provide details below to improve the information on CHOCTAW NATION OF OKLAHOMA.
| 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.