Spine Care of Oklahoma, LLC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

22294 Issued in OK

Legal business name

SPINE CARE OF OKLAHOMA, LLC

Practice address

508 W 15TH St
Edmond, OK 73013-3615

Phone

(405) 840-5100

Fax

(405) 840-5102

NPI assigned

Aug 23, 2007

Last updated

Aug 15, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Edward A Shadid, M.D.NPI 1275572398

Title

Business Owner

Phone

(405) 840-5100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edward A Shadid, M.D.

  • Pain Medicine Physician
  • Edmond, OK
  • NPI 1275572398
  Medicare reassignment Care Compare group NPD Authorized official
• Gentian Meta, M.D.

  • Interventional Pain Medicine Physician
  • Edmond, OK
  • NPI 1891907325
  Medicare reassignment Care Compare group NPD
• Tina C Small, MD

  • Physical Medicine & Rehabilitation Physician
  • Lawton, OK
  • NPI 1720074255
  Medicare reassignment Care Compare group NPD
• Megan Weaver, APRN, FNP-C

  • Family Nurse Practitioner
  • Lawton, OK
  • NPI 1396427613
  Medicare reassignment Care Compare group NPD
• Andrea Christine Lohmann, PA, OTR, CHT

  • Physician Assistant
  • Fort Sill, OK
  • NPI 1740307362
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1033302906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 W 15TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133615",
            "telephone_number": "405-615-0290",
            "fax_number": "405-840-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 W 15TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133615",
            "telephone_number": "405-840-5100",
            "fax_number": "405-840-5102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5900 Mosteller Dr",
            "address_2": "Suite 3",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731124600",
            "country_code": "US",
            "telephone_number": "405-840-5100",
            "fax_number": "405-840-5102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPINE CARE OF OKLAHOMA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-23",
        "last_updated": "2022-08-15",
        "certification_date": "2021-07-24",
        "status": "A",
        "authorized_official_last_name": "SHADID",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "405-840-5100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "OK",
            "license": "22294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Lorren Speights
• Lisa Louise Spence, APRN-CNP
• Colby L Spencer, DN
• Stephen Mark Spielman, M.D.
• Karla J Spilman
• Spinepainbegone PA
• Jaclyn Spomer
• Zaria Spratt
• Spring Creek Pharmacy LLC (Spring Creek Pharmacy)
• Meghan D Springer, OTR

• Preferred Provider Organization in Edmond, OK
• Providers in Edmond, OK by specialty
• Preferred Provider Organization in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.