Individual provider Active NPI

Mark Alan Sheaman, PAC

  • Physician Assistant
  • Ardmore, OK
National Provider Identifier
1417911181
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA484 Issued in OK
Practice address
2002 12TH Ave NW
Suite B
Ardmore, OK 73401-1206
Phone
(580) 223-4795
Fax
(580) 223-5184
NPI assigned
Apr 12, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA484 OK Primary

Addresses

Primary practice location

2002 12TH Ave NW
Suite B
Ardmore, OK 73401-1206

Mailing address

2002 12TH Ave NW
Suite B
Ardmore, OK 73401-1206
Phone (580) 223-4795

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100820000229 OK Practitioner - Physician Assistant 1951438910 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ortho Plus LLCGroup PAC ID 1052610524, 5 clinicians

Practice addresses (Care Compare)

941 W I 35 Frontage Rd
Suite 164
Edmond, OK 73034-7375
Phone (405) 285-2994

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA484OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ortho Plus LLC CurrentSince Dec 1, 2020 Accepting new patients
Ortho Plus Holdings LLC CurrentSince Dec 1, 2020 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

2419 N Commerce St
Ste B
Ardmore, OK 73401
Phone (580) 226-7587

301 Lilac Dr
Ste 140
Edmond, OK 73034
Phone (405) 906-3755

941 W I 35 Frontage Rd
Ste 164
Edmond, OK 73034
Phone (405) 285-2994

12301 S Western Ave
Ste A3
Oklahoma City, OK 73170
Phone (405) 200-1869

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13205/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mark.sheaman.1@13205.direct.athenahealth.com

Organizations & group practices 6

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 1

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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1417911181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 12TH AVE NW",
            "address_2": "SUITE B",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011206",
            "telephone_number": "580-223-4795",
            "fax_number": "580-223-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 12TH AVE NW",
            "address_2": "SUITE B",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011206",
            "telephone_number": "580-223-4795",
            "fax_number": "580-223-5184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEAMAN",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "PA484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, OK

Sources for this page

Verify at the official NPI Registry.