| Kaw Nation | |
|
3151 E. River Road Newkirk OK 74647 | |
| (580) 362-1039 | |
| (580) 362-2988 |
| Full Name | Kaw Nation |
|---|---|
| Speciality | Clinic/Center |
| Location | 3151 E. River Road, Newkirk, Oklahoma |
| Authorized Official Name and Position | Lea Blenz (MEDICAL BILLING/CREDENTIALING) |
| Authorized Official Contact | 5803621039 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kaw Nation Po Box 474 3151 E. River Road Newkirk OK 74647-0474 Ph: (580) 362-1039 | Kaw Nation 3151 E. River Road Newkirk OK 74647 Ph: (580) 362-1039 |
| NPI Number | 1487752465 |
|---|---|
| Provider Enumeration Date | 09/21/2006 |
| Last Update Date | 03/22/2022 |
| Medicare PECOS PAC ID | 4486542552 |
|---|---|
| Medicare Enrollment ID | O20151215000450 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487752465 | NPI | - | NPPES |
| 100809950B | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Melinda Allen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396737888 PECOS PAC ID: 6305757444 Enrollment ID: I20151215001159 |
| Provider Name | Janae Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073124764 PECOS PAC ID: 7214330281 Enrollment ID: I20210728002040 |
| Provider Name | Nicki J Carriere |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326528266 PECOS PAC ID: 8628472834 Enrollment ID: I20210811000012 |
| Provider Name | Jerry G Pritchett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811156615 PECOS PAC ID: 7315169836 Enrollment ID: I20211019000205 |
| Provider Name | Vicki A Derry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053574418 PECOS PAC ID: 5597921650 Enrollment ID: I20220304000702 |
| Provider Name | Courtney Beck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063069227 PECOS PAC ID: 5294192902 Enrollment ID: I20230611000170 |
| Provider Name | Sharon E Stewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275508749 PECOS PAC ID: 6507836681 Enrollment ID: I20250314001490 |
| Provider Name | Aeric W Creekmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144625732 PECOS PAC ID: 5890013445 Enrollment ID: I20250327002024 |
Newkirk Rural Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 601a W South St, Newkirk, OK 74647 Phone: 580-362-2555 Fax: 580-362-2091 | |
Fairfax Medical Facilities Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 716 S Highway 77, Newkirk, OK 74647 Phone: 580-362-2555 Fax: 580-362-2948 |