Northeastern State University
NPI 1194198192 · Orthopaedic Surgery Physician · Tahlequah, OK
Northeastern State University is a Orthopaedic Surgery Physician organization in Tahlequah, OK (NPI 1194198192).
Provider details
- NPI number
- 1194198192
- Entity type
- Organization
- Primary specialty
- Orthopaedic Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Mouzon Bass, Agent(972) 367-4845
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Northeastern State University Sports Medicine
Registry dates
- Enumerated
- 2015-11-12
- Last updated
- 2015-11-12
Frequently asked questions
- What is Northeastern State University's NPI number?
- Northeastern State University's National Provider Identifier (NPI) is 1194198192, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Northeastern State University?
- Northeastern State University is classified in the NPPES registry as Orthopaedic Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Northeastern State University located?
- Northeastern State University's practice location on file with NPPES is 603 N Grand Ave, Tahlequah, OK 74464-2302.
- What is Northeastern State University's phone number?
- The practice phone number listed in the NPPES registry for Northeastern State University is (918) 444-3921.
- Who is the authorized official for Northeastern State University?
- The authorized official listed on Northeastern State University's NPPES record is Mouzon Bass, Agent. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Northeastern State University's NPI active?
- Yes — Northeastern State University's NPI (1194198192) is active in the NPPES registry as of the last update on 2015-11-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.