NORTHEASTERN TRIBAL HEALTH SYSTEM (NPI# 1639267065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639267065 |
| Entity Type | Organization |
| Organization Name | NORTHEASTERN TRIBAL HEALTH SYSTEM |
| Practice Address |
7600 S Highway 69a Miami OK 74354-1016 |
| Mailing Address |
Po Box 1498 Miami OK 74355-1498 |
| Practice Telephone | 9185421655 |
| Practice Fax Number | 9185401685 |
| Mailing Telephone | 9185421655 |
| Mailing Fax Number | 9185401685 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2012-12-19 |
| Authorized Official Name | SHARON DAWES (HEALTH PROGRAM DIRECTOR) |
| Authorized Official Telephone | 9185421655 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTHEASTERN TRIBAL HEALTH SYSTEM |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 21-4318 | OK | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100700600B | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871522532 | Northeastern Tribal Health System | Clinic/Center | 7600 S Highway 69a, Miami, OK 74354-1016 | 2006-07-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NORTHEASTERN TRIBAL HEALTH SYSTEM | 7600 S Hwy 69a, Miami, OK 74354-1016 |
| Street Address |
7600 S HIGHWAY 69A |
| City | MIAMI |
| State | OK |
| Zip Code | 74354-1016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750373494 | Tommy Darrell Foreman | Family Medicine | 7600 S Highway 69a, Miami, OK 74354-1016 | 2005-08-18 |
| 1538648746 | Jody Ford | Registered Nurse | 7600 S Highway 69a, Miami, OK 74354-1016 | 2018-08-08 |
| 1265919872 | Jessica Ross | Dental Hygienist | 7600 S Highway 69a, Miami, OK 74354-1016 | 2018-07-26 |
| 1477030138 | Sonya Carper | Dental Hygienist | 7600 S Highway 69a, Miami, OK 74354-1016 | 2018-07-25 |
| 1659811297 | Jordan Douthit | Dietitian, Registered | 7600 S Highway 69a, Miami, OK 74354-1016 | 2017-03-01 |
| 1851775852 | Kyle Downum | Dentist | 7600 S Highway 69a, Miami, OK 74354-1016 | 2015-07-20 |
| 1497132690 | Kristen Marie Woodruff | Dietitian, Registered | 7600 S Highway 69a, Miami, OK 74354-1016 | 2015-04-27 |
| 1023442357 | Tonya Lynn Olsen | Registered Nurse | 7600 S Highway 69a, Miami, OK 74354-1016 | 2013-08-22 |
| 1093016461 | Emory Mitchell | Counselor | 7600 S Highway 69a, Miami, OK 74354-1016 | 2010-11-16 |
| 1124340880 | Channa Lee Morton | Dietitian, Registered | 7600 S Highway 69a, Miami, OK 74354-1016 | 2010-02-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447786603 | Coal Creek Counseling, LLC | Social Worker | 204 D St Ne, Miami, OK 74354 | 2017-05-10 |
| 1164958567 | Yco Tulsa, Inc | Counselor | 1458 E Steve Owens Blvd, Miami, OK 74354 | 2017-05-04 |
| 1982064226 | Yco Tulsa, Inc | Clinic/Center | 1519 E Steve Owens Blvd, Miami, OK 74354 | 2016-02-29 |
| 1548641285 | Courtney Marie Winfrey | Occupational Therapy Assistant | 310 2nd Ave Sw Fl 3, Miami, OK 74354 | 2015-06-17 |
| 1417338039 | Michelle Dawn Johnson | Case Manager/Care Coordinator | 1519 E. Steve Owens Blvd, Miami, OK 74354 | 2015-06-10 |
| 1790100337 | Jordan Taylor-threet | Speech-Language Pathologist | 2225 N. Main St., Miami, OK 74354 | 2014-02-19 |
| 1700137551 | Miami Healthcare, LLC | Skilled Nursing Facility | 2530 North Elm St., Miami, OK 74354 | 2012-09-19 |
| 1144507534 | Julia Brown | Pharmacist | 11 West Central, Miami, OK 74354 | 2011-11-14 |
| 1841504685 | Dodie A Giles Keith | Counselor | 33 C Street Northeast, Miami, OK 74354 | 2010-08-04 |
| 1013221571 | Katherine Renee Burke | Counselor | 111 S. Treaty Rd., Miami, OK 74354 | 2010-07-27 |
| Find all providers in zip 74354 | ||||
| Taxonomy Code | 332800000X |
| Grouping | Suppliers |
| Classification | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603. |
| Notes: Source: The Medicare Prescription Drug, Improvement and Modernization Act of 2003 [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639472970 | Carnegie Indian Health Clinic | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 212 E. 4th St, Carnegie, OK 73015 | 2010-12-08 |
| 1568512374 | Wewoka Ihs Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Intersection of Hwy 56 and 270, Wewoka, OK 74884 | 2007-01-12 |
| 1316097389 | Anadarko Ihs Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 115 Ne Old Town Rd, Anadarko, OK 73005-5009 | 2007-01-11 |
| 1538219431 | El Reno Ihs Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1801 Parkview Drive, El Reno, OK 73632 | 2007-01-11 |
| 1871663203 | Sac & Fox Nation | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 356110 E 930 Rd, Stroud, OK 74079-5184 | 2006-11-09 |
| 1699790543 | Li-si-wi-nwi Health, Inc | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 15951 Little Axe Drive, Norman, OK 73026-9001 | 2006-07-13 |
| 1952303190 | Pawhuska Ihs Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 715 Grandview Ave, Pawhuska, OK 74056-3201 | 2005-06-01 |
| 1568839470 | Osage Nation | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 715 Grandview Ave, Pawhuska, OK 74056-3201 | 2015-08-26 |
| 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 |
| 1598053993 | Citizen Potawatomi Nation West Clinic | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 781 Grand Casino Blvd, Shawnee, OK 74804-1005 | 2011-07-19 |
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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.