NPIMap

Organization Active NPI

Seretean Wellness Center

  • Internal Medicine Physician
  • Stillwater, OK
National Provider Identifier
1275670432
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SERETEAN WELLNESS CENTER
Practice address
1514 W Hall of Fame
Stillwater, OK 74078-0001
Phone
(405) 744-6211
Fax
(405) 744-8448
NPI assigned
Jan 30, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Tammy Shaffer
Title
Medical Manager Coordinator
Phone
(405) 744-6211

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X OK Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X OK

Addresses

Primary practice location

1514 W Hall of Fame
Stillwater, OK 74078-0001

Mailing address

1514 W Hall of Fame
Stillwater, OK 74078-0001
Phone (405) 744-6211

National Provider Directory

National Provider Directory
Tax ID family
Carl Albert Community M140 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1514 W Hall of Fame
Stillwater, OK 74078
Phone (405) 744-1359

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1275670432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 W HALL OF FAME",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740780001",
            "telephone_number": "405-744-6211",
            "fax_number": "405-744-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 W HALL OF FAME",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740780001",
            "telephone_number": "405-744-6211",
            "fax_number": "405-744-8448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERETEAN WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "SHAFFER",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "MEDICAL MANAGER COORDINATOR",
        "authorized_official_telephone_number": "405-744-6211"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": null,
            "primary": false
        }
    ],
    "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 Sep 11, 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.