Individual provider Active NPI

Jessica Alaine Shelton, M.S., CCC-A

  • Audiologist
  • Stillwater, OK
National Provider Identifier
1194940072
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
324 Issued in OK
Practice address
116 W 8TH Ave
Stillwater, OK 74074-4602
Phone
(405) 312-9358
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 324 OK Primary

Addresses

Primary practice location

116 W 8TH Ave
Stillwater, OK 74074-4602

Mailing address

116 W 8TH Ave
Stillwater, OK 74074-4602
Phone (405) 624-8605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190731003625 OK Practitioner - Qualified Audiologist 9638405400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. John Physicians, Inc.Group PAC ID 2567366495, 262 clinicians

Practice addresses (Care Compare)

1705 E 19TH St
Tulsa, OK 74104-5410

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
324OKMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Jun 23, 2025 Accepting new patients
St. John Physicians, Inc. CurrentSince Jun 23, 2025 Accepting new patients

Locations

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

Organizations & group practices 2

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": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1194940072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 W 8TH AVE",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744602",
            "telephone_number": "405-624-8605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 W 8TH AVE",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744602",
            "telephone_number": "405-312-9358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "JESSICA",
        "middle_name": "ALAINE",
        "name_prefix": "Ms.",
        "credential": "M.S., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OK",
            "license": "324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.