Individual provider Active NPI

Shateria Ru'Kelia Shannon

  • Case Management Agency
  • Oklahoma City, OK
National Provider Identifier
1235009770
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Practice address
1414 SW 89TH St Ste B
Oklahoma City, OK 73159-6312
Phone
(405) 458-5611
NPI assigned
Nov 10, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X OK Primary

Addresses

Primary practice location

1414 SW 89TH St Ste B
Oklahoma City, OK 73159-6312

Mailing address

801 Brookwood Dr Apt A01-107
Oklahoma City, OK 73139-4972
Phone (405) 801-7586

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1762732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1235009770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 BROOKWOOD DR APT A01-107",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731394972",
            "telephone_number": "405-801-7586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 SW 89TH ST STE B",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731596312",
            "telephone_number": "405-458-5611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "SHATERIA",
        "middle_name": "RU'KELIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-10",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; 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.