Serena E. Sheppard, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R0067512 Issued in OK

Practice address

1921 Stonecipher Blvd
Ada, OK 74820-3439

Phone

(580) 310-5687

NPI assigned

Jan 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Serena E Black Former name

Medicare fee-for-service enrollment

Enrolled in TX, OK2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chickasaw Nation Division of Health Chickasaw Nation Medical CenterGroup PAC ID 8426957523, 243 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Chickasaw Nation Medical Center Hospital, Ada, OK, CCN 370180

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ssheppard23551@direct.chickasawnationhealth.net

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.

• Chickasaw Nation Division of Health

  • General Acute Care Hospital
  • Ada, OK
  • NPI 1255364923

  TX

  Medicare reassignment Care Compare group NPD
• Chickasaw Nation Division of Health

  • Primary Care Clinic/Center
  • Ardmore, OK
  • NPI 1730249186
  NPD
• Purcell Municipal Hospital

  • General Acute Care Hospital
  • Purcell, OK
  • NPI 1467476911
  NPD
• Chickasaw Nation Division of Health Chickasaw Nation Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Ada, OK
  • NPI 1295399095
  NPD (past)

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

• Chickasaw Nation Division of Health

  • General Acute Care Hospital
  • Ada, OK
  • NPI 1255364923
  Care Compare affiliation
• Chickasaw Nation Division of Health

  • Primary Care Clinic/Center
  • Tishomingo, OK
  • NPI 1649330242

  Hospital

  Care Compare affiliation
• Chickasaw Nation Division of Health

  • Primary Care Clinic/Center
  • Ardmore, OK
  • NPI 1730249186

  Hospital

  Care Compare affiliation
• Chickasaw Nation Division of Health

  • Primary Care Clinic/Center
  • Purcell, OK
  • NPI 1982764395

  Hospital

  Care Compare affiliation
• Chickasaw Nation Division of Health Chickasaw Nation Medical Center

  • Primary Care Clinic/Center
  • Ada, OK
  • NPI 1962563148

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1609855410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 STONECIPHER BLVD",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748203439",
            "telephone_number": "580-310-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 STONECIPHER BLVD",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748203439",
            "telephone_number": "580-310-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPPARD",
        "first_name": "SERENA",
        "middle_name": "E.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "R0067512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SERENA",
            "last_name": "BLACK",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anthony Lee Shelton
• Jonathan Edward Shelton
• Dennis Shenenberger, LPC U/S
• Katelyn Lee Shepard, MSPS, LPC
• Christy Dawn Sheppard, LPC
• Jessica Lea Shores, M.S.W
• Carol Sue Short
• John C Siegle, MD
• Silagy Family Counseling LLC
• Bobbie Jean Simmons, LPC

• Nurse Practitioner in Ada, OK
• Providers in Ada, OK by specialty
• Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.