NPIMap

Organization Active NPI

SSM Health Care of Oklahoma, Inc.

Doing business as SSM Health St Anthony Hospital - Oklahoma City

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1487677456
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SSM HEALTH CARE OF OKLAHOMA, INC.
Doing business as
SSM Health St Anthony Hospital - Oklahoma City
Practice address
1000 N Lee Ave
Oklahoma City, OK 73102-1036
Phone
(405) 231-3857
Fax
(405) 272-4948
NPI assigned
Jul 25, 2006
Last updated
Apr 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Authorized official

Name
Shasta Rene Manuel
Title
VP Finance
Phone
(405) 272-7282

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU
Pain Medicine (Anesthesiology) Physician 207LP2900X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1000 N Lee Ave
Oklahoma City, OK 73102-1036

Mailing address

PO Box 958210
Saint Louis, MO 63195-8210
Phone (405) 231-3857

Other practice location 1

1110 N Lee Ave Ste 300
Oklahoma City, OK 73103-2612
Phone (405) 231-3000

Other names 1

  • SSM Health St Anthony Hospital - Oklahoma City Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040216000184 OK Part B Supplier - Clinic/Group Practice 6709771207 Receives reassigned benefits from 221 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Oklahoma City, OK; Oklahoma Citry, OK; Mustang, OK; Midwest City, OK; Choctaw, OK

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Saints Medical Group LLC114 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1110 N Lee Ave
Ste 300
Oklahoma City, OK 73103
Phone (405) 231-3000

1111 N Lee Ave
Ste 542
Oklahoma City, OK 73103
Phone (405) 272-7644

608 NW 9th St
Ste 1100
Oklahoma City, OK 73102
Phone (405) 231-3000

Practitioners & affiliated clinicians

Practitioners 79

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 79

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745884800000",
    "number": "1487677456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 958210",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631958210",
            "telephone_number": "405-231-3857",
            "fax_number": "405-272-7977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N LEE AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731021036",
            "telephone_number": "405-231-3857",
            "fax_number": "405-272-4948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1110 N Lee Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731032612",
            "country_code": "US",
            "telephone_number": "405-231-3000",
            "fax_number": "405-231-3073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SSM HEALTH CARE OF OKLAHOMA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A",
        "authorized_official_last_name": "MANUEL",
        "authorized_official_first_name": "SHASTA",
        "authorized_official_middle_name": "RENE",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "405-272-7282"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SSM Health St Anthony Hospital - Oklahoma City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.