NPIMap

Organization Active NPI

White Eagle Health Center

  • Clinic/Center
  • Ponca City, OK
National Provider Identifier
1699875724
Registry record updated May 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
WHITE EAGLE HEALTH CENTER
Practice address
200 White Eagle Drive
Ponca City, OK 74601
Phone
(580) 765-2501
Fax
(580) 765-6348
NPI assigned
Sep 25, 2006
Last updated
May 18, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2016

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

Authorized official

Name
Mr. Bennett Arkeketa
Title
Tribal Administrator
Phone
(580) 765-2501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

200 White Eagle Drive
Ponca City, OK 74601

Mailing address

200 White Eagle Drive
Ponca City, OK 74601
Phone (580) 765-2501

Other identifiers 1

IdentifierTypeStateIssuer
100700590DMedicaidOK

Other names 1

  • Ponca Tribal Health Authority Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040819000518 OK Part B Supplier - Clinic/Group Practice 1456324193 Receives reassigned benefits from 22 practitioners
1 other NPI on this enrollment
Practice locations: Ponca City, OK

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Hope and Recovery Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463529600000",
    "number": "1699875724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 WHITE EAGLE DRIVE",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "74601",
            "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 DRIVE",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "74601",
            "telephone_number": "580-765-2501",
            "fax_number": "580-765-6348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE EAGLE HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2016-05-18",
        "status": "A",
        "authorized_official_last_name": "ARKEKETA",
        "authorized_official_first_name": "BENNETT",
        "authorized_official_title_or_position": "TRIBAL ADMINISTRATOR",
        "authorized_official_telephone_number": "580-765-2501",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100700590D",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ponca Tribal Health Authority",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Ponca City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.