Sac & Fox Nation
Organization Active NPI Clinic/Center · Stroud, OK
NPI 1871663203 · NPPES record last updated Sep 12, 2019
Key facts
- NPI
- 1871663203
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 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
- Organization subpart
- No
Authorized official
- Name
- Sheri Brown
- Title
- Business Office Manager
- Phone
- (918) 968-9531
Practitioners 18
-
Andrea Nacole Beck, MS, RD/LD
-
Gregory Dunlevy, PT, DPT, CSCS
-
Jayne Deanne Fortenberry, CNP-FAMILY
-
Stephanie Green, APRN
-
Amber Dawn Morgan, APRN
-
Tyler Austin Rolette, D.P.T.
-
Jeanette Sue Thomas, FNP
-
James Edward Webb Jr., D.P.M.
-
Whytleigh Madicyn Barnes, PT, DPT
-
Christie R. Carpenter, APRN-FNP-CNP
-
Mary Lynn Peeks, FNP-C
-
Murat Sen, PA
-
Amanda Quary, APRN-CNP
-
Amanda Bighorse, D.O.
-
Linda Kay Blunt, M.D.
-
Tammy Hobbie, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040311000953 | OK | Part B Supplier - Clinic/Group Practice | 2668361379 |
Receives reassigned benefits from 18 practitioners Practice locations: Stroud, OK |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes | ||
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100729660A | Medicaid | OK | |
| 730078966-001 | Other | OK | BCBS OF OKLAHOMA |
Other providers in Stroud, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.