Individual provider Active NPI

Shanna Marie Schuelein O'Bannon

  • Professional Counselor
  • Oklahoma City, OK
National Provider Identifier
1366103707
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
10483 Issued in OK
Practice address
5208 W Reno Ave
Oklahoma City, OK 73127-6344
Phone
(405) 948-4900
NPI assigned
Jan 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 10483 OK Primary

Addresses

Primary practice location

5208 W Reno Ave
Oklahoma City, OK 73127-6344

Mailing address

5208 W Reno Ave
Oklahoma City, OK 73127-6344
Phone (405) 948-4900

Other names 1

  • Shanna Marie O'Bannon Other name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240715002432 TX Practitioner - Mental Health Counselor 3577008580 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central Oklahoma American Indian Health Council, Inc. CurrentSince Jul 8, 2024 Accepting new patients

Locations

4913 W Reno Ave
Oklahoma City, OK 73127
Phone (405) 948-4900

5208 W Reno Ave
Oklahoma City, OK 73127
Phone (405) 948-4900

309 S Ann Arbor Ave
Oklahoma City, OK 73128
Phone (405) 948-4900

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1366103707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5208 W RENO AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731276344",
            "telephone_number": "405-948-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5208 W RENO AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731276344",
            "telephone_number": "405-948-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BANNON",
        "first_name": "SHANNA",
        "middle_name": "MARIE SCHUELEIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-07",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "10483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNA",
            "last_name": "O'BANNON",
            "middle_name": "MARIE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.