Individual provider Active NPI

Shandy Rae Gosnell Stotler, APRN-CNP, DNP

  • Family Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1588100408
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
100569 Issued in OK
Practice address
800 NE 10TH St FL 6
Oklahoma City, OK 73104-5418
Phone
(405) 213-8009
NPI assigned
Jan 17, 2017
Last updated
Feb 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 100569 OK Primary

Addresses

Primary practice location

800 NE 10TH St FL 6
Oklahoma City, OK 73104-5418

Mailing address

800 NE 10TH St FL 6
Oklahoma City, OK 73104-5418
Phone (405) 213-8009

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
I20170327000698 OK Practitioner - Nurse Practitioner 4486939824 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ou Health Partners IncGroup PAC ID 5991105876, 1,167 clinicians

Practice addresses (Care Compare)

800 NE 10TH St
Ouhp Stephenson Cancer Center
Oklahoma City, OK 73104-5418
Phone (405) 271-1112

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.26 of 100Reported as group
Quality
53.73
Promoting interoperability
100
Improvement activities
40
Cost
70.48

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Feb 4, 2017 Accepting new patients
Ou Health Partners, Inc CurrentSince Apr 28, 2022 Accepting new patients
Ou Health Partners, Inc CurrentSince Apr 28, 2022 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Feb 4, 2017 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Ou Medicine Inc. Past Accepting new patients

Locations

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

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

920 Stanton L Young Blvd
#2410
Oklahoma City, OK 73104
Phone (405) 271-8777

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1588100408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 NE 10TH ST FL 6",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045418",
            "telephone_number": "405-213-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 NE 10TH ST FL 6",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045418",
            "telephone_number": "405-213-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOTLER",
        "first_name": "SHANDY",
        "middle_name": "RAE GOSNELL",
        "name_prefix": "Mrs.",
        "credential": "APRN-CNP, DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-17",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "100569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.