NPIMap

Organization Active NPI

Shadow Mountain Behavioral Health System, LLC

  • Medical Specialty Clinic/Center
  • Tulsa, OK
National Provider Identifier
1124037288
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM, LLC
Practice address
6262 S Sheridan Rd
Tulsa, OK 74133-4055
Phone
(918) 492-8200
Fax
(918) 493-3268
NPI assigned
Aug 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mrs. Sharon Worsham
Title
Chief Executive Officer
Phone
(918) 492-8200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X OK Primary

Addresses

Primary practice location

6262 S Sheridan Rd
Tulsa, OK 74133-4055

Mailing address

6262 S Sheridan Rd
Tulsa, OK 74133-4055
Phone (918) 492-8200

National Provider Directory

National Provider Directory
Tax ID family
Shadow Mountain Behavioral Health System15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1124037288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6262 S SHERIDAN RD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334055",
            "telephone_number": "918-492-8200",
            "fax_number": "918-493-3268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6262 S SHERIDAN RD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334055",
            "telephone_number": "918-492-8200",
            "fax_number": "918-493-3268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WORSHAM",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "918-492-8200",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.