Active NPI
Northeastern Tribal Health System
- Clinic/Center
- Miami, OK
National Provider Identifier
1871522532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- NORTHEASTERN TRIBAL HEALTH SYSTEM
- Doing business as
- Northeastern Tribal Health System
- Practice address
- 7600 S Highway 69a
Miami, OK 74354-1016 - Phone
- (918) 542-1655
- Fax
- (918) 540-1685
- NPI assigned
- Jul 2, 2006
- Last updated
- Aug 18, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rachel Lee Olsen, AUTHORIZED OFFICIAL
- Title
- Administrative Officer
- Phone
- (918) 322-4433
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | NU | Primary |
Addresses
Primary practice location
7600 S Highway 69a
Miami, OK 74354-1016
Mailing address
PO Box 1498
Miami, OK 74355-1498
Phone (918) 542-1655
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100700600D | Medicaid | OK |
Other names 1
- Northeastern Tribal Health System
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, OK
Enrollment records 2
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1871522532. Details of each certification follow.
Federally qualified health center certification: CCN 371910
- Legal name
- NORTHEASTERN TRIBAL HEALTH SYSTEM
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Mar 16, 2016
- Last certification
- Mar 16, 2016
- Ownership / control type
- For profit – corporation
- Organization structure
- Other
- Incorporated
- Sep 15, 2000 in OK
- Enrollment address
- 7600 S Highway 69a
Miami, OK 74354-1016
National Provider Directory
National Provider DirectoryLocations
2301 S Eight Tribes Trl
Miami, OK 74354
Phone (918) 540-1655
7600 S Highway 69A
Miami, OK 74354
Phone (918) 542-1655
Ownership & related parties
All disclosed owners & managing parties 4
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Lisa McGowen | W-2 Managing Employee | May 4, 2018 | |
| Northeastern Tribal Health System | Other | Sep 15, 2000 | 100% |
| Rachel Olsen | W-2 Managing Employee | May 30, 2017 | |
| Johnny Smith | Corporate Officer | Feb 17, 2020 | 100% |
| Corporate Director | Mar 2, 2020 | 100% | |
| W-2 Managing Employee | May 30, 2017 |
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Miami, OK
- NPI 1639267065
Practitioners & affiliated clinicians
Practitioners 43
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": "1151798400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1787011200000",
"number": "1871522532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1498",
"city": "MIAMI",
"state": "OK",
"postal_code": "743551498",
"telephone_number": "918-542-1655",
"fax_number": "918-540-1685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7600 S HIGHWAY 69A",
"city": "MIAMI",
"state": "OK",
"postal_code": "743541016",
"telephone_number": "918-542-1655",
"fax_number": "918-540-1685"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHEASTERN TRIBAL HEALTH SYSTEM",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-02",
"last_updated": "2026-08-18",
"certification_date": "2026-08-18",
"status": "A",
"authorized_official_last_name": "OLSEN",
"authorized_official_first_name": "RACHEL",
"authorized_official_middle_name": "LEE",
"authorized_official_title_or_position": "ADMINISTRATIVE OFFICER",
"authorized_official_telephone_number": "918-322-4433",
"authorized_official_credential": "AUTHORIZED OFFICIAL"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100700600D",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Northeastern Tribal Health System",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Miami, OK
- Neo Orthopedic and Rehabilitation LLC (NEO Orthopedics and Rehabilitation LLC)
- Leasa Nichols
- Terri Leanne Nino
- Kara D North, PNP
- Northeastern Tribal Health System
- Nova Therapy Works, P.L.L.C.
- NW Miami LLC (Express RX of Maimi)
- Cristina Marie Oakley, PHARMD
- Romeo Lapus Obsequio, MD
- Tonya Lynn Olsen, RN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.