Individual provider Active NPI

Shana Kaye-Clark Brown

  • Peer Specialist
  • Pauls Valley, OK
National Provider Identifier
1417898420
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
100 Valley Dr
Pauls Valley, OK 73075-6613
Phone
(405) 242-1618
NPI assigned
Apr 3, 2026
Last updated
Apr 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X OK Primary

Addresses

Primary practice location

100 Valley Dr
Pauls Valley, OK 73075-6613

Mailing address

522 S Elizabeth Ave
Pauls Valley, OK 73075-6404
Phone (405) 242-1618

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1775174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1417898420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 S ELIZABETH AVE",
            "city": "PAULS VALLEY",
            "state": "OK",
            "postal_code": "730756404",
            "telephone_number": "405-242-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 VALLEY DR",
            "city": "PAULS VALLEY",
            "state": "OK",
            "postal_code": "730756613",
            "telephone_number": "405-242-1618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SHANA",
        "middle_name": "KAYE-CLARK",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-03",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pauls Valley, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2026; 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.