Shante Marie Butts, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5114 Issued in OK

Practice address

1921 Stonecipher Dr
Ada, OK 74820-3439

Phone

(580) 436-3980

NPI assigned

Oct 27, 2023

Last updated

Jul 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sbutts23572@direct.chickasawnationhealth.net

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.

• Chickasaw Nation Division of Health

  dba Chickasaw Nation Medical Center

  • General Acute Care Hospital
  • Ada, OK
  • NPI 1255364923

  TX

  Medicare reassignment NPD (past)
• Chickasaw Nation Division of Health

  dba Chickasaw Nation Ardmore Clinic

  • Primary Care Clinic/Center
  • Ardmore, OK
  • NPI 1730249186
  NPD
• Chickasaw Nation Division of Health Chickasaw Nation Medical Center

  dba Minticha Apila

  • Home Health Agency
  • Ada, OK
  • NPI 1811739071
  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": "1698364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1174395602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18161 COUNTY ROAD 1545",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748205303",
            "telephone_number": "405-926-7299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 STONECIPHER DR",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748203439",
            "telephone_number": "580-436-3980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTTS",
        "first_name": "SHANTE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-27",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "5114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• October Lynnell Burris
• Charlotte Jean Burrough, LCSW
• Ashley Meredith Burrow
• Carla J Buske, BS, BHRS
• Lauren Butler
• Lauren Danette Byars-Griffin, LPC-C
• Laura Coleen Byous-Schaefer, APRN-CNM
• Brittany Byrd
• Jade Byrd
• Christopher Calaway

• Physician Assistant in Ada, OK
• Providers in Ada, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.