NPIMap

Organization Active NPI

Shannon G. Davis, Aprn-CNP Family, P.L.L.C

Doing business as The Yale Clinic

  • Primary Care Clinic/Center
  • Oklahoma City, OK
National Provider Identifier
1508292210
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
R69234 Issued in OK
Legal business name
SHANNON G. DAVIS, APRN-CNP FAMILY, P.L.L.C
Doing business as
The Yale Clinic
Practice address
3414 NW 135TH St
Oklahoma City, OK 73120-4009
Phone
(405) 414-1441
NPI assigned
Sep 25, 2013
Last updated
Feb 18, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Authorized official

Name
Shannon Gale Davis, APRN-CNPNPI 1477838217
Title
Family Nurse Practitioner
Phone
(405) 414-1441

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X R69234 OK Primary

Addresses

Primary practice location

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

Mailing address

3414 NW 135TH St
Oklahoma City, OK 73120-4009
Phone (405) 749-0900

Other practice location 1

617 W. Broadway
Yale, OK 74085-2509
Phone (405) 749-0900

Other identifiers 1

IdentifierTypeStateIssuer
200437870AMedicaidOK

Other names 1

  • The Yale Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

3414 NW 135th St
Ste B
Oklahoma City, OK 73120
Phone (405) 749-0900

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581984000000",
    "number": "1508292210",
    "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": "405-414-1441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "617 W. Broadway",
            "address_purpose": "LOCATION",
            "city": "Yale",
            "state": "OK",
            "postal_code": "740852509",
            "country_code": "US",
            "telephone_number": "405-749-0900",
            "fax_number": "405-260-9566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHANNON G. DAVIS, APRN-CNP FAMILY, P.L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-25",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "GALE",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "405-414-1441",
        "authorized_official_credential": "APRN-CNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OK",
            "license": "R69234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200437870A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Yale Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Yale Clinic",
            "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 Feb 18, 2020; 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.