NPIMap

Organization Active NPI

Choctaw Nation Health Services

  • Adolescent and Children Mental Health Clinic/Center
  • Idabel, OK
National Provider Identifier
1376826933
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
CHOCTAW NATION HEALTH SERVICES
Practice address
902 E Lincoln Rd
Idabel, OK 74745-7337
Phone
(580) 286-2600
Fax
(580) 286-1087
NPI assigned
Sep 21, 2011
Last updated
Jan 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Authorized official

Name
Teresa Jackson
Title
Administrator
Phone
(918) 567-7054

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU Primary

Addresses

Primary practice location

902 E Lincoln Rd
Idabel, OK 74745-7337

Mailing address

1 Choctaw Way
Talihina, OK 74571-2022
Phone (918) 567-7000

Other identifiers 1

IdentifierTypeStateIssuer
101Y00000XMedicaidOK

National Provider Directory

National Provider Directory
Tax ID family
Choctaw Nation Healthcare16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

902 E Lincoln Rd
Idabel, OK 74745
Phone (580) 286-2600

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706054400000",
    "number": "1376826933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHOCTAW WAY",
            "city": "TALIHINA",
            "state": "OK",
            "postal_code": "745712022",
            "telephone_number": "918-567-7000",
            "fax_number": "918-567-7066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 E LINCOLN RD",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747457337",
            "telephone_number": "580-286-2600",
            "fax_number": "580-286-1087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOCTAW NATION HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-21",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "918-567-7054"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101Y00000X",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Idabel, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.