Individual provider Active NPI

John C. Stepanek, D.O.

  • Emergency Medicine Physician
  • Shawnee, OK
National Provider Identifier
1568458941
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4021 Issued in OK
Practice address
1102 W Macarthur St
Shawnee, OK 74804-1743
Phone
(405) 878-8121
NPI assigned
Sep 21, 2005
Last updated
Mar 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4021 OK Primary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 4021 OK

Addresses

Primary practice location

1102 W Macarthur St
Shawnee, OK 74804-1743

Mailing address

1102 W Macarthur St
Shawnee, OK 74801
Phone (405) 878-8121

Other identifiers 1

IdentifierTypeStateIssuer
200015440AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, MO2 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
I20031118001033 OK Practitioner - Emergency Medicine 4486568805 Reassigns benefits to 2 organizations
I20140528001777 MO Practitioner - Emergency Medicine 4486568805 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Services of Oklahoma PC Emergency Medicine CurrentSince Nov 11, 2014 Accepting new patients
Southeastern Emergency Physicians of Memphis LLC Emergency Medicine CurrentSince Mar 1, 2018 Accepting new patients
South Central Emergency Services PC Emergency Medicine CurrentSince May 23, 2012 Accepting new patients
Seminole Health Center LLC Past Accepting new patients
Sterling Emergency Services of Oklahoma, Inc. Emergency Medicine Past Accepting new patients

Locations

5000 Hopyard Rd
Ste 100
Pleasanton, CA 94588
Phone (480) 861-4015

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1027 E Cherry St
Cushing, OK 74023
Phone (918) 225-2915

1800 W University Blvd
Durant, OK 74701
Phone (580) 924-3080

901 N Porter Ave
Norman, OK 73071
Phone (405) 307-1500

4050 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 608-3200

1900 N 14th St
Ponca City, OK 74601
Phone (580) 718-2932

111 N Bailey St
Pryor, OK 74361
Phone (918) 824-7791

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

Interoperability endpoints

  • Direct secure messaging: jstepanek23901@direct.okheart.com

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1568458941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 W MACARTHUR ST",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "74801",
            "telephone_number": "405-878-8121",
            "fax_number": "405-878-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 W MACARTHUR ST",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748041743",
            "telephone_number": "405-878-8121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPANEK",
        "first_name": "JOHN",
        "middle_name": "C.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "4021",
            "primary": true
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "OK",
            "license": "4021",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200015440A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, OK

Sources for this page

Verify at the official NPI Registry.