Individual provider Active NPI

Chauntel Joyce Ditommaso, PA

  • Physician Assistant
  • Hugo, OK
National Provider Identifier
1184098246
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1201 E Jackson St
Hugo, OK 74743-4229
Phone
(580) 326-6423
NPI assigned
Nov 30, 2015
Last updated
Apr 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OK Primary

Addresses

Primary practice location

1201 E Jackson St
Hugo, OK 74743-4229

Mailing address

1060 Braydan
Reno, TX 75462-5902
Phone (405) 795-4622

Other names 1

  • Ms. Chauntel Joyce Shannon Former name

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
I20160211000088 OK Practitioner - Physician Assistant 5092019018 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rowland Flatt ClinicGroup PAC ID 9830186824, 11 clinicians

Practice addresses (Care Compare)

603 NE 2ND St
Antlers, OK 74523-2636
Phone (580) 298-3351

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Infinity Aesthetic and Laser Center LLC PastSince Aug 9, 2020 Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1448841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1184098246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 BRAYDAN",
            "city": "RENO",
            "state": "TX",
            "postal_code": "754625902",
            "telephone_number": "405-795-4622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 E JACKSON ST",
            "city": "HUGO",
            "state": "OK",
            "postal_code": "747434229",
            "telephone_number": "580-326-6423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITOMMASO",
        "first_name": "CHAUNTEL",
        "middle_name": "JOYCE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-30",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHAUNTEL",
            "last_name": "SHANNON",
            "middle_name": "JOYCE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hugo, OK

Sources for this page

Verify at the official NPI Registry.