Shannon Medley, P.A.-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1614 Issued in OK

Practice address

1208 W 15TH St
Edmond, OK 73013-3001

Phone

(405) 340-2100

Fax

(405) 340-1184

NPI assigned

Jun 26, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

University of Oklahoma College of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

BDC Medical, PLLCGroup PAC ID 8325330798, 6 clinicians

Optimal Health Associates LLCGroup PAC ID 0446602536, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shannon.medley@3023.securemail.prognocis.com
• Direct secure messaging: smedley123189@directc.mercy.net

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.

• BDC Medical PLLC

  • Interventional Pain Medicine Physician
  • Oklahoma City, OK
  • NPI 1013387810
  Medicare reassignment Care Compare group
• Optimal Health Associates LLC

  • Gynecology Physician
  • Oklahoma City, OK
  • NPI 1881478303
  Medicare reassignment Care Compare group
• Mercy Clinic Oklahoma Communities

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1386874550
  Medicare reassignment
• BDC Medical PLLC

  • Interventional Pain Medicine Physician
  • Yukon, OK
  • NPI 1578359972
  NPD
• Mercy Health Network Inc

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1427097435
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416960000000",
    "number": "1376705806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 N MONTE VISTA",
            "address_2": "SUITE A",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748204675",
            "telephone_number": "580-436-7101",
            "fax_number": "580-436-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 W 15TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133001",
            "telephone_number": "405-340-2100",
            "fax_number": "405-340-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDLEY",
        "first_name": "SHANNON",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2014-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "1614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alex E Medgaarden, PA-C
• Medi Practice Management LLC
• Medical Enterprises Inc.
• Medical Resource Management, LLC
• Medical West Respiratory Central , LLC
• Medstaffpc
• Amanda Meehan, FNTP
• Megan Fletcher Counseling, LLC
• Megan Ibanez LLC
• Allison Marie Meier

• Medical Physician Assistant in Edmond, OK
• Providers in Edmond, OK by specialty
• Medical Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.