White Eagle Dialysis Center

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

WHITE EAGLE DIALYSIS CENTER

Practice address

200 White Eagle Dr
Ponca City, OK 74601-8315

Phone

(580) 765-2501

Fax

(580) 765-6348

NPI assigned

Jul 14, 2016

Last updated

Jul 14, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

PONCA TRIBE OF OKLAHOMAAs reported in NPPES

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

Authorized official

Name

Mr. Joseph Blan, RN

Title

Dialysis Director

Phone

(580) 765-2501

Specialties & licenses 1

Addresses

Part of

White Eagle Dialysis Center

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468454400000",
    "number": "1649623620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 WHITE EAGLE DR",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746018315",
            "telephone_number": "580-765-2501",
            "fax_number": "580-765-6348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WHITE EAGLE DR",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746018315",
            "telephone_number": "580-765-2501",
            "fax_number": "580-765-6348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE EAGLE DIALYSIS CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PONCA TRIBE OF OKLAHOMA",
        "enumeration_date": "2016-07-14",
        "last_updated": "2016-07-14",
        "status": "A",
        "authorized_official_last_name": "BLAN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "DIALYSIS DIRECTOR",
        "authorized_official_telephone_number": "580-765-2501",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wesley E. Nipper DDS PC
• Jenny West, MCP, LPC, LADC
• Lesa Ann Westra, LMSW, MSW U/S
• Alyssa Sterling Wheeler, HIS
• Phillip David Whetstone
• White Eagle Health Center (Hope and Recovery Center)
• White Eagle Health Center
• White Eagle Health Center
• Emma Brook White, MSW
• Andrew Quint Whitefield, DDS

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Ponca City, OK
• Providers in Ponca City, OK by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; 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.