David L Shadid, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

2930 Issued in OK

Practice address

4612 S Harvard
Ste a
Tulsa, OK 74135

Phone

(918) 747-5565

Fax

(918) 747-5568

NPI assigned

Dec 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Psychiatry

Education

Oklahoma State University College of Osteopathic Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• David L Shadid DO Inc

  • Psychiatry Physician
  • Tulsa, OK
  • NPI 1992898209
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385078400000",
    "number": "1508934126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4612 S HARVARD AVE",
            "address_2": "STE A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352908",
            "telephone_number": "918-747-5565",
            "fax_number": "918-747-5568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4612 S HARVARD",
            "address_2": "STE A",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74135",
            "telephone_number": "918-747-5565",
            "fax_number": "918-747-5568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADID",
        "first_name": "DAVID",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2013-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OK",
            "license": "2930",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OK",
            "license": "2930",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100129510A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• SH CCRC, LLC
• Ahmed Shaban
• Mohammed Shaban, DO
• L Kent Shacklett, D.D.S., M.S.D.
• Anna Claire Shadid
• Joanna Omega Shadlow, PHD
• Shadow Mountain Behavioral Health
• Shadow Mountain Behavioral Health Care System, LLC
• Shadow Mountain Behavioral Health System
• Shadow Mountain Behavioral Health System LLC

• Psychiatry Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Psychiatry Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2013; 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.