Absentee Shawnee Tribal Health Authority, Inc.
Organization Active NPI Multi-Specialty Clinic/Center · Norman, OK
NPI 1124152962 · NPPES record last updated Aug 12, 2026
Key facts
- NPI
- 1124152962
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- Legal business name
- ABSENTEE SHAWNEE TRIBAL HEALTH AUTHORITY, INC.
- Practice address
- 15951 Little Axe Dr
Norman, OK 73026-9088 - Phone
- (405) 447-0300
- Fax
- (405) 701-7914
- NPI assigned
- Mar 15, 2007
- Organization subpart
- No
Authorized official
- Name
- Marty Lofgren, MD, CPE
- Title
- Executive/ Medical Director
- Phone
- (405) 447-0300
Other NPIs on the same Medicare enrollment 1
Member organizations 1
Practitioners 46
-
Kara M Anady, PSYD
-
Mitchell Bloomquist, DPM
-
Shawn Bridwell, PA
-
Kari Dawn Campbell, APRN
-
Whitney L Crowe, MD
-
Rachel T Diaz, DO
-
Jill Floyd, PMHNP-BC
-
Brett William Frazier, MD, MPH
-
Eric Jay Harden, LPC, LADC
-
Tami Ranae Hernandez, MHR LPC
-
Brendon Hines, DO
-
Joy Lyn Kelley, PH.D.
-
Karl F. Langkamp, D.O.
-
Valerie Blanche Manning, D.O.
-
Ashish Kumar Masih, M.D.
-
Lindsay Marie Masquat Yellow Robe, MSW, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220414000294 | OK | Part B Supplier - Clinic/Group Practice | 5799171088 |
Receives reassigned benefits from 93 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Norman, OK; Shawnee, OK |
National Provider Directory
Locations
2029 Gordon Cooper Dr
Shawnee, OK 74801
Phone (405) 878-4702
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | |||
| Multi-Specialty Clinic/Center | 261QM1300X | OK | Yes |
Addresses
Primary practice location
15951 Little Axe Dr
Norman, OK 73026-9088
Mailing address
15951 Little Axe Dr
Norman, OK 73026-9088
Phone (405) 447-0300
Other practice location 1
15702 E State Highway 9
Norman, OK 73026-9028
Phone (405) 447-0477
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100699860O | Medicaid | OK | |
| 100699860N | Medicaid | OK | |
| 100699860P | Medicaid | OK | |
| 100699860A | Medicaid | OK | |
| 100699860H | Medicaid | OK | |
| 100699860I | Medicaid | OK |
Other names
- Absentee Shawnee Tribal Health System- Little Axe Health Center
Other providers in Norman, OK
- Oluwatobi Aborisade
- Elie Abou Nassar
- Linta Abraham
- Melinda Ann Abrahams
- Absentee Shawnee Tribal Health Authority, Inc.
- Absentee Shawnee Tribal Health Authority, Inc.
- Absentee Shawnee Tribal Health Authority, Inc.
- Amanda Abshure
- Abigail Janese Acceus
- Accident and Trauma Centers Inc
All providers in Norman, OK · Multi-Specialty Clinic/Center in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.