1. Home
  2. Directory
  3. Oklahoma
  4. Fort Gibson
  5. Clinic Center
  6. NPI Profile

NORTHEASTERN HEALTH SYSTEM
NPI 1013458652
Clinic/Center - Rural Health in Fort Gibson, OK

Active since March 15, 2017
104 LONE OAK CIR, FORT GIBSON, OK 74434(918) 478-2101(918) 478-6008 Get Directions Write a Review

NPPES record last updated: April 6, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 6, 2026, May 18, 2017, Mar 15, 2017 (3 updates tracked since 2017).

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

NPI1013458652
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameNORTHEASTERN HEALTH SYSTEM
Location Address104 LONE OAK CIRFort Gibson, OK 74434-5001
Mailing AddressPo Box 500Tahlequah, OK 74465-0500 · (918) 478-2101 · Fax (918) 478-6008
Phone(918) 478-2101
Fax(918) 478-6008
Organization SubpartNo
Authorized OfficialJulie WardCfo · (918) 453-2120
Enumeration DateMarch 15, 2017
Last NPPES UpdateApril 6, 20263 updates tracked since enumeration
NPPES CertifiedApril 6, 2026
✔ NPI 1013458652 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
104 LONE OAK CIR, Fort Gibson, OK 74434
Open in Google Maps ↗

Other Names 1

Doing Business AsFort Gibson Medical Clinic

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.

MRS. SUSAN MARIE MILLER FNP-C
Nurse Practitioner (Primary Care)
104 LONE OAK CIR
FORT GIBSON, OK 74434
Muskogee County (918) 478-2101
MARVIN MOUL
Internal Medicine
104 LONE OAK CIR
FORT GIBSON, OK 74434
Muskogee County (918) 478-2101

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.

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 4 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.