Active NPI
Shon D. Kendall, D.O.
- Emergency Medical Services (Emergency Medicine) Physician
- Tulsa, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medical Services (Emergency Medicine) Physician
- License
- 4084
- Practice address
- 1717 S Utica Ave Ste a
Tulsa, OK 74104-5346 - Phone
- (918) 748-7557
- Fax
- (918) 748-7514
- NPI assigned
- Oct 24, 2005
- Last updated
- Apr 13, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | 4084 | OK | Primary |
Addresses
Primary practice location
1717 S Utica Ave Ste a
Tulsa, OK 74104-5346
Mailing address
1515 N Harvard Ave
Ste E
Tulsa, OK 74115-4957
Phone (918) 832-6050
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200040170A | Medicaid | OK |
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 93.51 of 100
- Quality
- 84.87
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4084 | OK | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Medicine Physicians of Tulsa County, LLC | Current | Accepting new patients | |
| St. John Physicians, Inc | Current | Accepting new patients | |
| St. John Physicians, Inc. | Current | Accepting new patients | |
| St John Urgent Care Clinics Inc | Past | Accepting new patients | |
| Owasso Medical Facility, Inc | Past | Accepting new patients | |
| St. John Broken Arrow, Inc | Past | Accepting new patients | |
| St John Sapulpa, Inc. | Past | Accepting new patients |
Locations
1000 W Boise Cir
Broken Arrow, OK 74012
Phone (918) 994-8000
12451 E 100th St N
Owasso, OK 74055
Phone (918) 274-5000
1004 E Bryan Ave
Sapulpa, OK 74066
Phone (918) 224-4280
10501 E 91st St
Tulsa, OK 74133
Phone (918) 307-6000
1515 N Harvard Ave
Ste E
Tulsa, OK 74115
Phone (918) 832-6049
1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585
1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660
1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345
Interoperability endpoints
- shon.kendall.1@18337.direct.athenahealth.com
- shon.kendall@direct.stjohnhealthsystem.com
Organizations & group practices 7
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Emergency Medicine Physician
- Tulsa, OK
- NPI 1003098773
-
- Internal Medicine Physician
- Tulsa, OK
- NPI 1336194406
-
dba Siggins Memorial Clinic
- Rural Health Clinic/Center
- Barnsdall, OK
- NPI 1033176367
-
dba St. John Owasso
- General Acute Care Hospital
- Owasso, OK
- NPI 1144231432
-
- Critical Access Hospital
- Sapulpa, OK
- NPI 1922076603
-
- Urgent Care Clinic/Center
- Tulsa, OK
- NPI 1003918830
-
dba Ascension St. John Jenks
- General Acute Care Hospital
- Broken Arrow, OK
- NPI 1497988596
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271116800000",
"number": "1063402865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 N HARVARD AVE",
"address_2": "STE E",
"city": "TULSA",
"state": "OK",
"postal_code": "741154957",
"telephone_number": "918-832-6050",
"fax_number": "918-832-6055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 S UTICA AVE STE A",
"city": "TULSA",
"state": "OK",
"postal_code": "741045346",
"telephone_number": "918-748-7557",
"fax_number": "918-748-7514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENDALL",
"first_name": "SHON",
"middle_name": "D.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-24",
"last_updated": "2010-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "207PE0004X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": "OK",
"license": "4084",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200040170A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2010; 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.