Derek J Shadid, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

24344 Issued in OK

Practice address

13904 Quailbrook Dr
Oklahoma City, OK 73134-1702

Phone

(405) 755-4451

Fax

(405) 755-6053

NPI assigned

Nov 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: dshadid59624@ouhealth.direct-ci.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210809600000",
    "number": "1487726881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13904 QUAILBROOK DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731341702",
            "telephone_number": "405-755-4451",
            "fax_number": "405-755-6053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13904 QUAILBROOK DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731341702",
            "telephone_number": "405-755-4451",
            "fax_number": "405-755-6053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADID",
        "first_name": "DEREK",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2008-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OK",
            "license": "24344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shadid Plastic Surgery Associates
• Anna Leigh Shadid, MD
• Betsy Ann Shadid, M.D.
• Christopher Charles Shadid, M.D.
• David Brian Shadid, DDS MSD
• Edward A Shadid, M.D.
• Edward A Shadid, M.D.
• Jamie Jill Shadid, R. PH., MBA
• Jeff Shadid, D.D.S.
• Nanay Laporte Shadid, DDS

• Specialist in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.