NPIMap

Organization Active NPI

Tahlequah City Hospital

  • General Practice Physician
  • Tahlequah, OK
National Provider Identifier
1083947378
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
2178 Issued in OK
Legal business name
TAHLEQUAH CITY HOSPITAL
Practice address
1400 E Downing St
Tahlequah, OK 74464-3324
Phone
(918) 456-0641
Fax
(918) 453-2341
NPI assigned
Sep 17, 2009
Last updated
Apr 6, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
TAHLEQUAH HOSPITAL AUTHORITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
James Theodore Berry
Title
Ceo
Phone
(918) 453-2263

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 2178 OK Primary

Addresses

Primary practice location

1400 E Downing St
Tahlequah, OK 74464-3324

Mailing address

PO Box 1008
Tahlequah, OK 74465-1008
Phone (918) 456-0641

Other names 1

  • TMG Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031125000250 OK Part B Supplier - Clinic/Group Practice 1456255025 Receives reassigned benefits from 159 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tahlequah, OK; Sallisaw, OK

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Tahlequah City Hospital7 organizations share this tax ID, including this one
Part of
Tahlequah City Hospital

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 28

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1253145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775433600000",
    "number": "1083947378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1008",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744651008",
            "telephone_number": "918-456-0641",
            "fax_number": "918-453-2341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E DOWNING ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643324",
            "telephone_number": "918-456-0641",
            "fax_number": "918-453-2341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAHLEQUAH CITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TAHLEQUAH HOSPITAL AUTHORITY",
        "enumeration_date": "2009-09-17",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "THEODORE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "918-453-2263"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OK",
            "license": "2178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TMG",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tahlequah, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.