Individual provider Active NPI

Shawna Renea Segraves Duncan, DO

  • Pediatrics Physician
  • Tulsa, OK
National Provider Identifier
1568431328
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
3716 Issued in OK
Practice address
717 S Houston Ave FL 4
Tulsa, OK 74127-9023
Phone
(918) 382-4600
Fax
(918) 382-3183
NPI assigned
Mar 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 3716 OK Primary

Addresses

Primary practice location

717 S Houston Ave FL 4
Tulsa, OK 74127-9023

Mailing address

717 S Houston Ave FL 4
Tulsa, OK 74127-9023
Phone (918) 382-4600

Other identifiers 1

IdentifierTypeStateIssuer
100103160BMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100512001051 OK Practitioner - Pediatric Medicine 0345378360 Reassigns benefits to 1 organization
I20230411000221 TX Practitioner - Pediatric Medicine 0345378360 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
3716OKMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation Current Accepting new patients
Jackson County Memorial Hospital Authority CurrentSince Jun 8, 2023 Accepting new patients
Cherokee Nation CurrentSince Jan 3, 2023 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Oklahoma State University CurrentSince Jan 1, 2020 Accepting new patients
Oklahoma State University CurrentSince Jan 1, 2020 Accepting new patients
Jackson County Memorial Hospital Authority CurrentSince Jun 8, 2023 Accepting new patients
Cherokee Nation CurrentSince Jan 3, 2023 Accepting new patients
Saint Francis Hospital, Inc. Past Accepting new patients
Cherokee Nation Past Accepting new patients

Locations

205 S Park Ln
Ste 210
Altus, OK 73521
Phone (580) 379-6650

1200 E Pecan St
Altus, OK 73521
Phone (580) 379-5000

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

042 Murray
Stillwater, OK 74078
Phone (405) 744-6021

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

19600 E Ross St
Tahlequah, OK 74464
Phone (539) 234-1000

Dept 2269
Tulsa, OK 74182

2401 Southwest Blvd
Tulsa, OK 74107

Dept 2563
Tulsa, OK 74182

2345 Southwest Blvd
Tulsa, OK 74107
Phone (918) 582-1980

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Interoperability endpoints

  • Direct secure messaging: sduncan51039@direct.saintfrancis.com

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1568431328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 S HOUSTON AVE FL 4",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741279023",
            "telephone_number": "918-382-4600",
            "fax_number": "918-382-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 S HOUSTON AVE FL 4",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741279023",
            "telephone_number": "918-382-4600",
            "fax_number": "918-382-3183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGRAVES DUNCAN",
        "first_name": "SHAWNA",
        "middle_name": "RENEA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "3716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100103160B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.