Shawnee MRI Associates, L.L.C.

Primary specialty

Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X

Legal business name

SHAWNEE MRI ASSOCIATES, L.L.C.

Doing business as

Shawnee Open MRI

Practice address

3700 N Kickapoo Ave
Suite 116
Shawnee, OK 74804-1707

Phone

(405) 275-6747

Fax

(405) 275-6749

NPI assigned

Jun 20, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Randall Wayne Wickersham

Title

VP of Operations

Phone

(405) 418-2200

Specialties & licenses 1

Addresses

Other names 1

• Shawnee Open MRI Doing business as

Locations

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346285483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 N KICKAPOO AVE",
            "address_2": "SUITE 116",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748041707",
            "telephone_number": "405-275-6747",
            "fax_number": "405-275-6749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 N KICKAPOO AVE",
            "address_2": "SUITE 116",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748041707",
            "telephone_number": "405-275-6747",
            "fax_number": "405-275-6749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWNEE MRI ASSOCIATES, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WICKERSHAM",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "405-418-2200"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shawnee Open MRI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shawnee Eye Associates, PLLC (Shawnee Vision Source)
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• Shawnee Medical Center Clinic, Inc (SSM Health Shawnee Behavorial Health Clinic)
• Shawnee Medical Center Clinic, Inc (SSM Health Radiation Oncology Shawnee)
• Shawnee Pedorthic Service, Inc.
• Shawnee Physical Therapy PC
• Shawnee Public Schools
• Shawnee Regional Hospital Pharmacy
• Shawnee Regional Pharmacy Inc (The Clinic Pharmacy)

• Magnetic Resonance Imaging (MRI) Clinic/Center in Shawnee, OK
• Providers in Shawnee, OK by specialty
• Magnetic Resonance Imaging (MRI) Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.