Joanna Omega Shadlow, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1172 Issued in OK

Practice address

550 S Peoria Ave
Tulsa, OK 74120-3820

Phone

(918) 588-1900

Fax

(918) 582-6405

NPI assigned

Jan 14, 2008

Last updated

Oct 16, 2026By 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

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Sallisaw, OK
  • NPI 1780692723

  TX

  Medicare reassignment NPD
• Indian Health Care Resource Center

  • Clinic/Center
  • Tulsa, OK
  • NPI 1427034958

  TX

  Medicare reassignment
• Cherokee Nation

  dba Cherokee Nation Public Health

  • Public Health or Welfare Agency
  • Tahlequah, OK
  • NPI 1013884154
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Muskogee, OK
  • NPI 1841207156
  NPD
• Indian Health Care Resource Center of Tulsa, Inc.

  • Pharmacy
  • Tulsa, OK
  • NPI 1457447609
  NPD (past)

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792108800000",
    "number": "1316123946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S PEORIA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741203820",
            "telephone_number": "918-588-1900",
            "fax_number": "918-582-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S PEORIA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741203820",
            "telephone_number": "918-588-1900",
            "fax_number": "918-582-6405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADLOW",
        "first_name": "JOANNA",
        "middle_name": "OMEGA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-14",
        "last_updated": "2026-10-16",
        "certification_date": "2026-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OK",
            "license": "1172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID/SOONERCARE",
            "identifier": "100732910-A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "73-1042545",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP TRICARE",
            "identifier": "731042545001",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP COMMUNITY CARE OF OKLAHOMA",
            "identifier": "73-1042545",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP BCBS",
            "identifier": "73-1042545",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID/SOONERCARE",
            "identifier": "100732910-G",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ahmed Shaban
• Mohammed Shaban, DO
• L Kent Shacklett, D.D.S., M.S.D.
• Anna Claire Shadid
• David L Shadid, DO
• Shadow Mountain Behavioral Health
• Shadow Mountain Behavioral Health Care System, LLC (Shadow Mountain Behavioral Health Care System)
• Shadow Mountain Behavioral Health System
• Shadow Mountain Behavioral Health System LLC (Shadow Mountain Behavioral Health System Pharmacy)
• Shadow Mountain Behavioral Health System, LLC (Shadow Mountain Behavioral Health System)

• Psychologist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Psychologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2026; 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.