Individual provider Active NPI

Shawn E. Minor, D.O.

  • Addiction Medicine (Preventive Medicine) Physician
  • Tahlequah, OK
National Provider Identifier
1366438715
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X
License
3974 Issued in OK
Practice address
19600 E Ross St
Tahlequah, OK 74464-0545
Phone
(918) 506-7559
NPI assigned
Sep 21, 2005
Last updated
Sep 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 3974 OK
Addiction Medicine (Preventive Medicine) Physician 2083A0300X 3974 OK Primary

Addresses

Primary practice location

19600 E Ross St
Tahlequah, OK 74464-0545

Mailing address

1717 S Utica Ave Ste a
Tulsa, OK 74104-5346
Phone (866) 321-8433

Other practice location 1

1200 N Muskogee Pl
Claremore, OK 74017-3058
Phone (918) 341-2556

Other practice location 2

1334 N Lansing Ave
Tulsa, OK 74106-5907
Phone (918) 587-2171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040115001131 OK Practitioner - Emergency Medicine 2668373374 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Morton Comprehensive Health Services IncGroup PAC ID 1951297621, shared by 6 NPIs, 29 clinicians
St John Urgent Care Clinics IncGroup PAC ID 5890898084, 29 clinicians

Practice addresses (Care Compare)

1334 N Lansing Ave
Tulsa, OK 74106-5907
Phone (918) 587-2171

1717 S Utica Ave
Suite a
Tulsa, OK 74104-5346
Phone (918) 748-1300

1910 S Falcon Ave
Claremore, OK 74019-2237
Phone (918) 343-6855

402 W Morrow Rd
Sand Springs, OK 74063-6549
Phone (918) 245-1119

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.51 of 100Reported as group
Quality
84.87
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
3974OKMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Physicians of Tulsa County, LLC CurrentSince Oct 1, 2024 Accepting new patients
St John Urgent Care Clinics Inc CurrentSince Sep 22, 2025 Accepting new patients
St. John Physicians, Inc CurrentSince May 22, 2012 Accepting new patients
Morton Comprehensive Health Services, Inc Current Accepting new patients
St. John Physicians, Inc. CurrentSince May 22, 2012 Accepting new patients
Morton Comprehensive Health Services, Inc CurrentSince May 1, 2025 Accepting new patients
Morton Comprehensive Health Services, Inc. CurrentSince May 1, 2025 Accepting new patients
Norstar Emergency Physicians Emergency Medical Services Past Accepting new patients
Seminole Health Center LLC Past Accepting new patients
Southcrest Emergency Physicians PC Emergency Medical Services Past Accepting new patients
St. John Broken Arrow, Inc Past Accepting new patients

Locations

1000 W Boise Cir
Broken Arrow, OK 74012
Phone (918) 994-8000

1004 E Bryan Ave
Sapulpa, OK 74066
Phone (918) 224-4280

10501 E 91st St
Tulsa, OK 74133
Phone (918) 307-6000

1334 N Lansing Ave
Tulsa, OK 74106

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

1717 S Utica Ave
Ste A
Tulsa, OK 74104
Phone (918) 748-1300

Interoperability endpoints

  • Direct secure messaging: shawn.minor@direct.stjohnhealthsystem.com

Organizations & group practices 11

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789603200000",
    "number": "1366438715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 S UTICA AVE STE A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045346",
            "telephone_number": "866-321-8433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19600 E ROSS ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744640545",
            "telephone_number": "918-506-7559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N Muskogee Pl",
            "address_purpose": "LOCATION",
            "city": "Claremore",
            "state": "OK",
            "postal_code": "740173058",
            "country_code": "US",
            "telephone_number": "918-341-2556",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1334 N Lansing Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741065907",
            "country_code": "US",
            "telephone_number": "918-587-2171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINOR",
        "first_name": "SHAWN",
        "middle_name": "E.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "OK",
            "license": "3974",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "OK",
            "license": "3974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahlequah, OK

Sources for this page

Verify at the official NPI Registry.