NORTHEASTERN HEALTH SYSTEM
NPI 1013458652
Clinic/Center - Rural Health in Fort Gibson, OK
About Northeastern Health System NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NORTHEASTERN HEALTH SYSTEM (NPI 1013458652), doing business as Fort Gibson Medical Clinic, is a healthcare organization registered as a rural health in Fort Gibson, Oklahoma and active in the NPI registry since March 2017. The organization lists Julie Ward, Cfo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment and revalidation status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Northeastern Health System is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FORT GIBSON, OK 74434
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Northeastern Health System's NPI number?
The NPI number for Northeastern Health System is 1013458652. It was assigned to this organization in the NPPES registry on March 15, 2017. The provider is doing business as Fort Gibson Medical Clinic.
Where is Northeastern Health System located?
Northeastern Health System is located at 104 Lone Oak Cir, Fort Gibson, OK 74434. The listed phone number is (918) 478-2101.
What is Northeastern Health System's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.
Is Northeastern Health System enrolled in Medicare?
Yes. Northeastern Health System is registered in the Medicare PECOS enrollment system.
When is Northeastern Health System's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Part A enrollment for this organization (Oklahoma, Hospital) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
When was this NPI record last updated?
The NPPES record for Northeastern Health System was last updated on April 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Northeastern Health System · NPI 1013458652
Rural Health organization in Fort Gibson, Oklahoma. Organization record, active in the CMS NPPES registry since March 15, 2017.
## Identity
- **NPI:** 1013458652 (Entity type: Organization)
- **Enumerated:** March 15, 2017
- **Primary specialty:** Clinic/Center - Rural Health · taxonomy 261QR1300X
- **Also known as:** Fort Gibson Medical Clinic (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Julie Ward, CFO
## Practice location
- **Address:** 104 LONE OAK CIR, Fort Gibson, OK 74434-5001
- **Phone:** (918) 478-2101 · **Fax:** (918) 478-6008
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Part A, Oklahoma, Hospital) · CMS Revalidation Due Date List, October 2026 release
## Record status
- **NPPES last updated:** April 6, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1013458652) · Data from the CMS NPPES public registry.