COMMUNITY HEALTH CENTER OF NORTHEAST OKLAHOMA, INC. (NPI# 1821410648) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821410648 |
| Entity Type | Organization |
| Organization Name | COMMUNITY HEALTH CENTER OF NORTHEAST OKLAHOMA, INC. |
| Other Organization Name | ROUTE 66 HEALTH CLINIC |
| Practice Address |
138 S. Main Street Afton OK 74331-0000 |
| Mailing Address |
Po Box 705 Afton OK 74331-0705 |
| Practice Telephone | 9182578029 |
| Practice Fax Number | 9182578042 |
| Mailing Telephone | 9182578029 |
| Mailing Fax Number | 9182578042 |
| Enumeration Date | 2014-01-14 |
| Last Update Date | 2020-02-19 |
| Authorized Official Name | PATRICK PEER (CEO) |
| Authorized Official Telephone | 9182578029 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Route 66 Health Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699318550 | Community Health Center of Northeast Oklahoma, Inc. | Clinic/Center | 220 S Mickey Mantle Blvd, Commerce, OK 74339-2924 | 2019-10-23 |
| Street Address |
138 S. MAIN STREET |
| City | AFTON |
| State | OK |
| Zip Code | 74331-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437374832 | Melinda K Bailey | Nurse Practitioner | 138 S. Main Street, Afton, OK 74331-0705 | 2007-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578114575 | Tena Kennon | Technician | 54301 East 250 Road, Afton, OK 74331 | 2019-09-23 |
| 1376920660 | Dayspring Community Services | Community/Behavioral Health | 3 Southeast 1st St, Afton, OK 74331 | 2015-05-06 |
| 1578742383 | Chiropractic Associates of Miami | Clinic/Center | 30650 S. Lakeside Dr., Afton, OK 74331 | 2007-10-29 |
| 1174735088 | Integrity Emergency Medical Services of Oklahoma LLC | Ambulance | 104 Sw 1st Street, Afton, OK 74331 | 2007-05-04 |
| 1043371198 | Courtland Prentice Smith Jr. | Otolaryngology | 26300 South Hwy 125, Afton, OK 74331 | 2006-12-13 |
| 1710920152 | Debra Maxton Miller | Counselor | 138 S. Main, Afton, OK 74331 | 2006-06-14 |
| 1639654429 | Sheena Nidiffer | Peer Specialist | 138 S. Main St, Afton, OK 74331 | 2018-09-27 |
| 1003397084 | Jaime Joseph Siegmann | Peer Specialist | 138 S Main St, Afton, OK 74331 | 2018-08-27 |
| 1730674508 | Caleigh Nichols | Social Worker | 138 S Main St, Afton, OK 74331 | 2018-06-25 |
| 1326539768 | Tim R Lucas | Peer Specialist | 138 S Main, Afton, OK 74331 | 2018-05-22 |
| Find all providers in zip 74331 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902404965 | Variety Care, Inc. | Clinic/Center | 201 Ne 50th St Ste 117, Oklahoma City, OK 73105-1811 | 2020-10-13 |
| 1699318550 | Community Health Center of Northeast Oklahoma, Inc. | Clinic/Center | 220 S Mickey Mantle Blvd, Commerce, OK 74339-2924 | 2019-10-23 |
| 1013567940 | Community Health Center of Southeast Kansas, Inc. | Clinic/Center | 7 S 1st St, Wyandotte, OK 74370-2268 | 2019-09-12 |
| 1013569961 | Community Health Connection, Inc. | Clinic/Center | 13702 E 46th Pl, Tulsa, OK 74134-5919 | 2019-07-11 |
| 1184286726 | Central Oklahoma Family Medical Center, Inc | Clinic/Center | 302 W Smith Street, Stratford, OK 74872-4648 | 2019-07-03 |
| 1982263752 | Shortgrass Community Health Center, Inc | Clinic/Center | 211 East Broadway, Altus, OK 73521 | 2019-06-06 |
| 1265902589 | Community Health Center of Northeast Oklahoma | Clinic/Center | 244 S Scraper Suite D, Vinita, OK 74301-3716 | 2018-11-29 |
| 1063988673 | Central Oklahoma Family Medical Center, Inc | Clinic/Center | 905 Colony Drive Bldg, Ada, OK 74820 | 2018-10-22 |
| 1306352547 | Variety Care, Inc. | Clinic/Center | 721 W Britton Rd, Oklahoma City, OK 73114-2909 | 2017-12-26 |
| 1568976991 | Arkansas Verdigris Valley Health Centers,inc. | Clinic/Center | 201 North 32nd Street, Muskogee, OK 74401-2104 | 2017-11-21 |
| 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.