NPIMap

Organization Active NPI

Creek Nation Hospital & Clinics

Doing business as Sapulpa Indian Health Center

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Sapulpa, OK
National Provider Identifier
1457460321
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyTaxonomy code 332800000X
License
11-4109 Issued in OK
Legal business name
CREEK NATION HOSPITAL & CLINICS
Doing business as
Sapulpa Indian Health Center
Practice address
1125 E Cleveland Ave
Sapulpa, OK 74066-4641
Phone
(918) 224-9310
Fax
(918) 756-2464
NPI assigned
Aug 30, 2006
Last updated
Dec 7, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
MUSCOGEE (CREEK) NATION DEPARTMENT OF HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Authorized official

Name
Shawn Terry, PHARMD
Title
Secretary of Health
Phone
(918) 756-9909

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X 11-4109 OK Primary
Community/Retail Pharmacy 3336C0003X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

1125 E Cleveland Ave
Sapulpa, OK 74066-4641

Mailing address

MCN Pharmacy
Dept # 1249
Tulsa, OK 74182-0001
Phone (918) 756-9909

Other identifiers 2

IdentifierTypeStateIssuer
100709130CMedicaidOK
2075853OtherPK

Other names 1

  • SAPULPA INDIAN 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
O20231211002782 OK DME Supplier - Indian Health Service Or Tribal FacilityDME Supplier - Pharmacy 5698786226 Practice locations: Sapulpa, OK

Other NPIs with the same Medicare PAC ID 16

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Creek Nation Hospital and Clinics84 organizations share this tax ID, including this one
Part of
Creek Nation Hospital and Clinics

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Creek Nation Community HospitalOkemah, OK, CCN 37Z333 Hospital Operational/Managerial Control Nov 1, 2007

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701907200000",
    "number": "1457460321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MCN PHARMACY",
            "address_2": "DEPT # 1249",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741820001",
            "telephone_number": "918-756-9909",
            "fax_number": "918-756-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 E CLEVELAND AVE",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740664641",
            "telephone_number": "918-224-9310",
            "fax_number": "918-756-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEK NATION HOSPITAL & CLINICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MUSCOGEE (CREEK) NATION DEPARTMENT OF HEALTH",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A",
        "authorized_official_last_name": "TERRY",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "SECRETARY OF HEALTH",
        "authorized_official_telephone_number": "918-756-9909",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": "OK",
            "license": "11-4109",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100709130C",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2075853",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAPULPA INDIAN HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SAPULPA INDIAN HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sapulpa, OK

Sources for this page

Verify at the official NPI Registry.