NPIMap

Organization Active NPI

Sac & Fox Nation

  • Clinic/Center
  • Stroud, OK
National Provider Identifier
1871663203
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SAC & FOX NATION
Practice address
356110 E 930 Rd
Stroud, OK 74079-5184
Phone
(918) 968-9531
Fax
(918) 968-9057
NPI assigned
Nov 9, 2006
Last updated
Sep 12, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Authorized official

Name
Sheri Brown
Title
Business Office Manager
Phone
(918) 968-9531

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X

Addresses

Primary practice location

356110 E 930 Rd
Stroud, OK 74079-5184

Mailing address

356110 E 930 Rd
Stroud, OK 74079-5184
Phone (918) 968-9531

Other identifiers 2

IdentifierTypeStateIssuer
100729660AMedicaidOK
730078966-001OtherOKBCBS OF OKLAHOMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040311000953 OK Part B Supplier - Clinic/Group Practice 2668361379 Receives reassigned benefits from 18 practitioners
Practice locations: Stroud, OK

National Provider Directory

National Provider Directory

Locations

356110 E 930 Rd
Stroud, OK 74079
Phone (918) 968-9531

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568246400000",
    "number": "1871663203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356110 E 930 RD",
            "city": "STROUD",
            "state": "OK",
            "postal_code": "740795184",
            "telephone_number": "918-968-9531",
            "fax_number": "918-968-9057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356110 E 930 RD",
            "city": "STROUD",
            "state": "OK",
            "postal_code": "740795184",
            "telephone_number": "918-968-9531",
            "fax_number": "918-968-9057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAC & FOX NATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2019-09-12",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "SHERI",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "918-968-9531"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100729660A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF OKLAHOMA",
            "identifier": "730078966-001",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stroud, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; 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.