Shannon Gale Davis, APRN CNP FAMILY

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R0069234 Issued in OK

Practice address

3414 NW 135TH St
Oklahoma City, OK 73120-4009

Phone

(405) 749-0900

Fax

(405) 749-0913

NPI assigned

Oct 12, 2011

Last updated

Feb 17, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rural Wellness Stroud IncGroup PAC ID 7113310491, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rural Wellness Stroud Hospital Hospital, Stroud, OK, CCN 371316

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shannondavis@rwhanadarko.medalliesdirect.net

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.

• Rural Wellness Stroud Inc.

  • Medical Specialty Clinic/Center
  • Stroud, OK
  • NPI 1609532282
  Medicare reassignment Care Compare group
• Rural Wellness Anadarko Inc

  • Medical Specialty Clinic/Center
  • Anadarko, OK
  • NPI 1538825120
  Medicare reassignment NPD
• Rural Wellness Fairfax Inc

  dba Rural Wellness Fairfax Hospital

  • Critical Access Hospital
  • Fairfax, OK
  • NPI 1295362564
  Medicare reassignment NPD
• Shannon G. Davis, Aprn-CNP Family, P.L.L.C

  dba The Yale Clinic

  • Primary Care Clinic/Center
  • Oklahoma City, OK
  • NPI 1508292210
  Authorized official Same address or phone
• Rha Anadarko Inc

  dba The Physicians Hospital In Anadarko

  • Critical Access Hospital
  • Anadarko, OK
  • NPI 1023076304
  NPD
• Rural Wellness Anadarko Inc

  dba Rural Wellness Anadarko Hospital

  • Critical Access Hospital
  • Anadarko, OK
  • NPI 1023774601
  NPD
• Rural Wellness Fairfax Inc

  dba Rural Wellness Fairfax Clinic

  • Rural Health Clinic/Center
  • Fairfax, OK
  • NPI 1790314466
  NPD
• Integris Rural Health Inc

  dba INTEGRIS Canadian Valley OBGYN

  • Obstetrics & Gynecology Physician
  • Yukon, OK
  • NPI 1245231307
  NPD (past)
• Integris Rural Health Inc

  dba Integris Canadian Valley Family Care Clinic

  • Family Medicine Physician
  • Mustang, OK
  • NPI 1962403030
  NPD (past)
• Rha Stroud Inc

  dba Stroud Regional Medical Center

  • Critical Access Hospital
  • Stroud, OK
  • NPI 1437107117
  NPD (past)

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

• Rural Wellness Stroud Inc.

  dba Rural Wellness Stroud Hospital

  • Critical Access Hospital
  • Stroud, OK
  • NPI 1932865508
  Care Compare affiliation

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

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1477838217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3414 NW 135TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731204009",
            "telephone_number": "405-749-0900",
            "fax_number": "405-749-0913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3414 NW 135TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731204009",
            "telephone_number": "405-749-0900",
            "fax_number": "405-749-0913"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "617 W. Broadway",
            "address_purpose": "LOCATION",
            "city": "Yale",
            "state": "OK",
            "postal_code": "74085",
            "country_code": "US",
            "telephone_number": "405-749-0900",
            "fax_number": "405-749-0913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SHANNON",
        "middle_name": "GALE",
        "name_prefix": "Ms.",
        "credential": "APRN CNP FAMILY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-12",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0069234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "R0069234",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200437870A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Regan Davis, LCSW
• Robert H. Davis
• Ryan Glenn Davis, MD
• Samantha Kathleen Davis
• Sarah Paige Whitson Davis, MD
• Sharice Davis, DDS
• Shasta Tomeka Davis, BHCM
• Shawn B Davis, MD
• Shelly A. Davis, PTA
• Sir Lawrence Davis

• Family Nurse Practitioner in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; 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.