NPIMap

Organization Active NPI

Osu Center for Health Sciences

  • Clinic/Center
  • Chouteau, OK
National Provider Identifier
1609633247
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
OSU CENTER FOR HEALTH SCIENCES
Practice address
108 W. Main Street
Chouteau, OK 74337
Phone
(918) 561-8306
Fax
(918) 280-1917
NPI assigned
Feb 29, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Authorized official

Name
Eric John Polak
Title
Vice President of Admin/Finance
Phone
(918) 561-8422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

108 W. Main Street
Chouteau, OK 74337

Mailing address

700 N Greenwood Ave RM 372
Tulsa, OK 74106-0702
Phone (918) 561-8306

Other names 1

  • OSU-AJ UTICA PARK CLINIC CHOUTEAU Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D1076263Utica Park Clinic - Chouteau108 W Main St, Chouteau, OK 74337Certificate of waiverDec 31, 2027

National Provider Directory

National Provider Directory
Tax ID family
Oklahoma State University223 organizations share this tax ID, including this one

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

NPI Registry JSON

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

{
    "created_epoch": "1709164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1609633247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N GREENWOOD AVE RM 372",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741060702",
            "telephone_number": "918-561-8306",
            "fax_number": "918-280-1917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 W. MAIN STREET",
            "city": "CHOUTEAU",
            "state": "OK",
            "postal_code": "74337",
            "telephone_number": "918-561-8306",
            "fax_number": "918-280-1917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSU CENTER FOR HEALTH SCIENCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-28",
        "status": "A",
        "authorized_official_last_name": "POLAK",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "VICE PRESIDENT OF ADMIN/FINANCE",
        "authorized_official_telephone_number": "918-561-8422"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OSU-AJ UTICA PARK CLINIC CHOUTEAU",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chouteau, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.