Shawn Fadum, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

2640 Issued in OK

Practice address

1104 Walnut Dr
Ardmore, OK 73401-2353

Phone

(580) 226-0543

Fax

(580) 226-2284

NPI assigned

Jan 19, 2016

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Group practices

Quick Urgent Care LLCGroup PAC ID 4486937505, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Quick Urgent Care LLC

  • Urgent Care Clinic/Center
  • Moore, OK
  • NPI 1467995589
  Medicare reassignment Care Compare group NPD
• Superior Family Care, LLC

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1720846835
  NPD
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1013374271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 WALNUT DR",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734012353",
            "telephone_number": "580-226-0543",
            "fax_number": "580-226-2284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 WALNUT DR",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734012353",
            "telephone_number": "580-226-0543",
            "fax_number": "580-226-2284"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1306 12th Ave NW",
            "address_purpose": "LOCATION",
            "city": "Ardmore",
            "state": "OK",
            "postal_code": "734011285",
            "country_code": "US",
            "telephone_number": "580-223-6004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FADUM",
        "first_name": "SHAWN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "2640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Excel-Ardmore LLC
• Exceptional Physicians Group Ardmore Hospital PLLC
• Eye Solutions Inc
• Hannah Ezell
• Samantha Ezell
• Jazman L Fagan
• Family Health Skilled Services LLC
• Family Practice Associates
• Family Shelter of Southern Oklahoma
• Family Shelter of Southern Oklahoma for Victims of Domestic Violence

• Medical Physician Assistant in Ardmore, OK
• Providers in Ardmore, OK by specialty
• Medical Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.