Individual provider Active NPI

Shelly Schoonover, APRN, CNP

  • Family Nurse Practitioner
  • Muskogee, OK
National Provider Identifier
1083169403
Registry record updated Jun 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
68346 Issued in OK
Practice address
1328 S York St
Muskogee, OK 74403-7650
Phone
(918) 683-0470
NPI assigned
Aug 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 68346 OK Primary

Addresses

Primary practice location

1328 S York St
Muskogee, OK 74403-7650

Mailing address

PO Box 751
Hulbert, OK 74441-0751
Phone (918) 772-3390

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160929000229 OK Practitioner - Nurse Practitioner 3274820675 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2343 N York St
Muskogee, OK 74403-1422
Phone (918) 348-1883

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Oklahoma Community Health Centers Inc CurrentSince Aug 3, 2016 Accepting new patients
Advanced Practice Care LLC CurrentSince Dec 16, 2024 Accepting new patients
Northeastern Oklahoma Community Health Centers, Inc CurrentSince Aug 3, 2016 Accepting new patients
Northeastern Oklahoma Community Health Centers Inc Current Accepting new patients

Locations

124 E Main St
Hulbert, OK 74441
Phone (918) 772-2879

1328 S York St
Muskogee, OK 74403
Phone (918) 682-2527

1500 E Downing St
Ste 201
Tahlequah, OK 74464
Phone (918) 772-3390

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1083169403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751",
            "city": "HULBERT",
            "state": "OK",
            "postal_code": "744410751",
            "telephone_number": "918-772-3390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 S YORK ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744037650",
            "telephone_number": "918-683-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOONOVER",
        "first_name": "SHELLY",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-16",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "68346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

Verify at the official NPI Registry.