Individual provider Active NPI

Shannon Ann Foresman, PA-C

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1578458618
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5639 Issued in OK
Practice address
940 Stanton L Young Blvd Ste 415
Oklahoma City, OK 73104-5020
Phone
(405) 271-4700
NPI assigned
Jun 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5639 OK Primary

Addresses

Primary practice location

940 Stanton L Young Blvd Ste 415
Oklahoma City, OK 73104-5020

Mailing address

940 Stanton L Young Blvd Ste 415
Oklahoma City, OK 73104-5020
Phone (405) 271-4700

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251022003038 OK Practitioner - Physician Assistant 1254829112 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Hospital Partners of OklahomaGroup PAC ID 6800241225, 24 clinicians

Practice addresses (Care Compare)

3401 W Gore Blvd
Lawton, OK 73505-6332
Phone (254) 879-4900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5639OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ou Health Partners, Inc CurrentSince Oct 6, 2025 Accepting new patients
Ou Health Partners, Inc CurrentSince Oct 6, 2025 Accepting new patients

Locations

700 NE 13th St
Oklahoma City, OK 73104
Phone (405) 271-3667

940 Stanton L Young Blvd
Ste 415
Oklahoma City, OK 73104
Phone (405) 271-2422

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

Organizations & group practices 3

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": "1749513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1578458618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 STANTON L YOUNG BLVD STE 415",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045020",
            "telephone_number": "405-271-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 STANTON L YOUNG BLVD STE 415",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045020",
            "telephone_number": "405-271-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORESMAN",
        "first_name": "SHANNON",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-10",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "5639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.