Shanon Elizabeth Paxson

Primary specialty

Private VehicleTaxonomy code 347C00000X

License

1000670490C Issued in OK

Practice address

25322 S 603 Rd
Grove, OK 74344

Phone

(918) 787-4368

NPI assigned

Jun 27, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1376740019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25322 S 603 RD",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "74344",
            "telephone_number": "918-787-4368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25322 S 603 RD",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "74344",
            "telephone_number": "918-787-4368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAXSON",
        "first_name": "SHANON",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "OK",
            "license": "1000670490A",
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "OK",
            "license": "1000670490C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHCA",
            "identifier": "1000670490C",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHCA",
            "identifier": "1000670490A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Douglas Allen Ohlstrom, M.D., F.A.C.S.
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• Modina Pelley
• Chad A Perkins, PA-C

• Private Vehicle in Grove, OK
• Providers in Grove, OK by specialty
• Private Vehicle in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.