NPIMap

Organization Active NPI

St Anthony Shawnee Hospital Inc

  • Surgery Physician
  • Shawnee, OK
National Provider Identifier
1619260411
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
ST ANTHONY SHAWNEE HOSPITAL INC
Practice address
1102 W Macarthur St
Shawnee, OK 74804-1743
Phone
(405) 878-8110
Fax
(405) 878-8101
NPI assigned
May 26, 2011
Organization subpart
Yes
Parent organization
SSM HEALTH CARE OF OKLAHOMA, INC.As reported in NPPES

Authorized official

NPPES NPI Registry
Name
Mr. Shasta Manuel
Title
VP Finance
Phone
(405) 272-7282

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 44

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 44

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121015000218 OK Part B Supplier - Clinic/Group Practice 1052567328 Receives reassigned benefits from 31 practitioners
1 other NPI on this enrollment
Practice locations: Shawnee, OK

National Provider Directory

National Provider Directory
Part of
Marilyn Doughtery MD

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X OK
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

NPPES NPI Registry

Primary practice location

1102 W Macarthur St
Shawnee, OK 74804-1743

Mailing address

1102 W Macarthur St
Shawnee, OK 74804-1743
Phone (405) 878-8110

Other names 1

NPPES NPI Registry
  • St Anthony Shawnee Hospital Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 5, 2025.

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754352000000",
    "number": "1619260411",
    "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": "748041743",
            "telephone_number": "405-878-8110",
            "fax_number": "405-878-8101"
        },
        {
            "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": "405-878-8110",
            "fax_number": "405-878-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST ANTHONY SHAWNEE HOSPITAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSM HEALTH CARE OF OKLAHOMA, INC.",
        "enumeration_date": "2011-05-26",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A",
        "authorized_official_last_name": "MANUEL",
        "authorized_official_first_name": "SHASTA",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "405-272-7282",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OK",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Anthony Shawnee Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shawnee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.