NPIMap

Organization Active NPI

Clinton Indian Health Center

  • Federal Public Health Clinic/Center
  • Clinton, OK
National Provider Identifier
1205923448
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federal Public Health Clinic/CenterTaxonomy code 261QP0904X
Legal business name
CLINTON INDIAN HEALTH CENTER
Doing business as
Clinton Indian Health Center
Practice address
10321 N 2274 Rd
Clinton, OK 73601-7521
Phone
(580) 331-3404
Fax
(580) 331-3565
NPI assigned
Oct 9, 2006
Last updated
Nov 26, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
LAWTON INDIAN HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Authorized official

Name
Mr. Joe Bryant
Title
Area Director
Phone
(580) 331-3315

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federal Public Health Clinic/Center 261QP0904X Primary

Addresses

Primary practice location

10321 N 2274 Rd
Clinton, OK 73601-7521

Mailing address

RR 1 Box 3060
Clinton, OK 73601-9303
Phone (580) 331-3404

Other names 1

  • CLINTON INDIAN HEALTH CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040121000506 TX Part B Supplier - Clinic/Group Practice 2163324237 Receives reassigned benefits from 160 practitioners
Practice locations: Clinton, OK
O20070712000757 OK Part A Provider - Hospital 6406800234 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wewoka, OK; Watonga, OK; Pawnee, OK; Lawton, OK; Clinton, OK; El Reno, OK; Anadarko, OK; Carnegie, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1205923448. Details of each certification follow.

Hospital certification: CCN 370170

Legal name
LAWTON INDIAN HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Mar 9, 1977
Last certification
May 28, 2025
Beds
26
Ownership / control type
Tribal
Organization structure
OtherNon-profit
Enrollment address
1515 NE Lawrie Tatum Rd
Lawton, OK 73507-3002
Other Hospital Practice Location
Hospital subgroups
General, Other

Other NPIs on the same Medicare enrollment 5

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Lawton Indian HospitalCCN 370170 · All quality measures
Type
Acute Care Hospitals
Ownership
Tribal
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Lawton IHS Pharmacy9 organizations share this tax ID, including this one
Part of
Lawton IHS Pharmacy

Other organizations with this tax ID 8

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3625 NW 56th St
Oklahoma City, OK 73112
Phone (918) 458-3100

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Greggory J Woitte Individual Corporate OfficerChief Medical Officer Feb 1, 2025
W-2 Managing EmployeeMD; Feb 1, 2025
Brian Wren Individual Corporate OfficerCeo Aug 14, 2023
W-2 Managing EmployeeCeo Aug 14, 2023
Travis E Watts Individual Corporate DirectorArea Office Director Jul 1, 2019
W-2 Managing EmployeeDirector Aug 12, 2018

Practitioners & affiliated clinicians

Practitioners 169

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 169

Affiliated clinicians 163

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 163

NPI Registry JSON

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574726400000",
    "number": "1205923448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 1 BOX 3060",
            "city": "CLINTON",
            "state": "OK",
            "postal_code": "736019303",
            "telephone_number": "580-331-3404",
            "fax_number": "580-331-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10321 N 2274 RD",
            "city": "CLINTON",
            "state": "OK",
            "postal_code": "736017521",
            "telephone_number": "580-331-3404",
            "fax_number": "580-331-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTON INDIAN HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAWTON INDIAN HOSPITAL",
        "enumeration_date": "2006-10-09",
        "last_updated": "2019-11-26",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "AREA DIRECTOR",
        "authorized_official_telephone_number": "580-331-3315",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP0904X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, Federal",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLINTON INDIAN HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton, OK

Sources for this page

Verify at the official NPI Registry.