NPIMap

Organization Active NPI

Absentee Shawnee Tribal Health Authority, Inc.

Doing business as Absentee Shawnee Tribal Health System- Little Axe Health Center

  • Multi-Specialty Clinic/Center
  • Norman, OK
National Provider Identifier
1124152962
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ABSENTEE SHAWNEE TRIBAL HEALTH AUTHORITY, INC.
Doing business as
Absentee Shawnee Tribal Health System- Little Axe Health Center
Practice address
15951 Little Axe Dr
Norman, OK 73026-9088
Phone
(405) 447-0300
Fax
(405) 701-7914
NPI assigned
Mar 15, 2007
Last updated
Aug 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Authorized official

Name
Marty Lofgren, MD, CPENPI 1861464752
Title
Executive/ Medical Director
Phone
(405) 447-0300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Multi-Specialty Clinic/Center 261QM1300X OK Primary

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 6

IdentifierTypeStateIssuer
100699860AMedicaidOK
100699860OMedicaidOK
100699860IMedicaidOK
100699860NMedicaidOK
100699860PMedicaidOK
100699860HMedicaidOK

Other names 1

  • Absentee Shawnee Tribal Health System- Little Axe Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

15702 E State Highway 9
Norman, OK 73026
Phone (405) 447-0300

15951 Little Axe Dr
Norman, OK 73026
Phone (405) 447-0300

Practitioners & affiliated clinicians

Practitioners 48

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 48

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786492800000",
    "number": "1124152962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15951 LITTLE AXE DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730269088",
            "telephone_number": "405-447-0300",
            "fax_number": "405-701-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15951 LITTLE AXE DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730269088",
            "telephone_number": "405-447-0300",
            "fax_number": "405-701-7914"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15702 E State Highway 9",
            "address_purpose": "LOCATION",
            "city": "Norman",
            "state": "OK",
            "postal_code": "730269028",
            "country_code": "US",
            "telephone_number": "405-447-0477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ABSENTEE SHAWNEE TRIBAL HEALTH AUTHORITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A",
        "authorized_official_last_name": "LOFGREN",
        "authorized_official_first_name": "MARTY",
        "authorized_official_title_or_position": "EXECUTIVE/ MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "405-447-0300",
        "authorized_official_credential": "MD, CPE"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100699860A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100699860O",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100699860I",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100699860N",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100699860P",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100699860H",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Absentee Shawnee Tribal Health System- Little Axe Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norman, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.