Shannon Renee Brady-Bardsher, ARNP
Individual provider Active NPI Family Nurse Practitioner · Chickasha, OK
NPI 1316211600 · NPPES record last updated Oct 9, 2014
Key facts
- NPI
- 1316211600
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 83612 (OK)
- Practice address
- 2220 W Iowa Ave
Chickasha, OK 73018-2738 - Phone
- (405) 779-2834
- NPI assigned
- Mar 3, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Williams Medical Group Practice, LLC
Practice addresses (Care Compare)
6744 NW Cache Rd
Xpress Wellness Urgent Care
Lawton, OK 73505-2702
Phone (580) 536-9355
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.91 of 100
- Quality
- 76.55
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141014000948 | OK | Practitioner - Nurse Practitioner | 6305067497 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grady Memorial Hospital | Current | Accepting new patients | |
| Grady Memorial Hospital | Current | Accepting new patients | |
| Ies HSP Oklahoma LLC | Current |
Accepting new patients | |
| Grady Memorial Hospital | Current | Accepting new patients | |
| Williams Medical Group Practice, LLC | Current |
Accepting new patients | |
| Williams Medical Group Practice, LLC | Current |
Accepting new patients | |
| Grady Memorial Hospital | Current |
Accepting new patients | |
| Grady Memorial Hospital | Current |
Accepting new patients | |
| Total Wound Care of Oklahoma, LLC | Current |
Accepting new patients | |
| Grady Memorial Hospital | Current |
Accepting new patients |
Locations
2220 W Iowa Ave
Chickasha, OK 73018
Phone (405) 224-2100
2100 W Iowa Ave
Ste A
Chickasha, OK 73018
Phone (405) 224-2100
2100 W Iowa Ave
Chickasha, OK 73018
Phone (405) 224-2100
220 S Van Buren St
Enid, OK 73703
Phone (580) 234-9355
6744 NW Cache Rd
Lawton, OK 73505
Phone (580) 536-9355
5602 SW Lee Blvd
Lawton, OK 73505
Phone (580) 531-4700
1900 NW Expressway
Ste 800
Oklahoma City, OK 73118
Phone (405) 246-0812
777 NW 63rd St
Fl 2
Oklahoma City, OK 73116
113 S Rush Ave
Rush Springs, OK 73082
Phone (580) 476-2527
4805 E Highway 37
Tuttle, OK 73089
Phone (405) 381-9979
Interoperability endpoints
- sbardsher@direct.gradymem.org
- sbardsher141547@direct-ehr-ssmhc.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 83612 | OK | Yes |
Addresses
Primary practice location
2220 W Iowa Ave
Chickasha, OK 73018-2738
Mailing address
2220 W Iowa Ave
Chickasha, OK 73018-2738
Phone (405) 779-2834
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200452510A | Medicaid | OK |
Other providers in Chickasha, OK
- Sherry Lynn Borden
- Jacob Duane Boyd
- Gary Allen Boyer
- Bradley Bibb MD PLLC
- Katelin Bradshaw
- Jessica Bragg
- Brooke Brandt
- Pam Brandt
- Andrew B Bratton
- Brookdale Senior Living Communities, Inc.
All providers in Chickasha, OK · Family Nurse Practitioner in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.