Active NPI
Shadow Mountain Behavioral Health System, LLC
- Psychiatric Hospital
- Tulsa, OK
National Provider Identifier
1528089257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Hospital
- License
- 2240
- Legal business name
- SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM, LLC
- Practice address
- 6262 S Sheridan Rd
Tulsa, OK 74133-4055 - Phone
- (918) 492-8200
- Fax
- (918) 493-3268
- NPI assigned
- Jul 21, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Steve Filton
- Title
- Sr VP Cfo
- Phone
- (610) 768-3300
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital | 283Q00000X | 2240 | OK | Primary |
Addresses
Primary practice location
6262 S Sheridan Rd
Tulsa, OK 74133-4055
Mailing address
6262 S Sheridan Rd
Tulsa, OK 74133-4055
Phone (918) 492-8200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200006820A | Medicaid | OK |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1305158400000",
"number": "1528089257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6262 S SHERIDAN RD",
"city": "TULSA",
"state": "OK",
"postal_code": "741334055",
"telephone_number": "918-492-8200",
"fax_number": "918-493-3268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6262 S SHERIDAN RD",
"city": "TULSA",
"state": "OK",
"postal_code": "741334055",
"telephone_number": "918-492-8200",
"fax_number": "918-493-3268"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-21",
"last_updated": "2011-05-12",
"status": "A",
"authorized_official_last_name": "FILTON",
"authorized_official_first_name": "STEVE",
"authorized_official_title_or_position": "SR VP CFO",
"authorized_official_telephone_number": "610-768-3300"
},
"taxonomies": [
{
"code": "283Q00000X",
"taxonomy_group": "",
"desc": "Psychiatric Hospital",
"state": "OK",
"license": "2240",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200006820A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tulsa, OK
- Shadow Mountain Behavioral Health System LLC
- Shadow Mountain Behavioral Health System, LLC
- Shadow Mountain Behavioral Health System, LLC
- Shadow Mountain Behavioral Health System, LLC
- Shadow Mountain Behavioral Health System, LLC
- Shadow Mountain Behavioral Health System, LLC
- Shadow Mountain Behavioral Health System, LLC
- Shadow Mountain Behavioral Health System, LLC
- Shadow Mountain Behavioral Health System, LLC
- Shadow Mountain Behavioral Health System, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.