Shelly Dawn Mansker, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R69284 Issued in OK

Practice address

31870 Hwy 51
Coweta, OK 74429

Phone

(918) 279-3200

Fax

(918) 279-1118

NPI assigned

Apr 19, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Shelly Dawn Loftin Former name

Medicare fee-for-service enrollment

Enrolled in OK, TX2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shelly.mansker@929604392124420.direct.elationemr.com

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.

• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Sallisaw, OK
  • NPI 1780692723

  TX

  Medicare reassignment NPD
• Faisal Wasi MD, PC

  • Infectious Disease Physician
  • Muskogee, OK
  • NPI 1265757827

  OK

  Medicare reassignment NPD
• Triad Complete Healthcare A07

  • Family Medicine Physician
  • Muskogee, OK
  • NPI 1063118529

  OK

  Medicare reassignment NPD
• Cherokee Nation

  • Public Health or Welfare Agency
  • Tahlequah, OK
  • NPI 1013884154
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Muskogee, OK
  • NPI 1841207156
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Stilwell, OK
  • NPI 1992711345
  NPD
• Green Country Infectious Disease PC

  • Infectious Disease Physician
  • Broken Arrow, OK
  • NPI 1639639321
  NPD (past)

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384732800000",
    "number": "1639436348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31870 HWY 51",
            "city": "COWETA",
            "state": "OK",
            "postal_code": "744294429",
            "telephone_number": "918-279-3200",
            "fax_number": "918-279-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31870 HWY 51",
            "city": "COWETA",
            "state": "OK",
            "postal_code": "74429",
            "telephone_number": "918-279-3200",
            "fax_number": "918-279-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSKER",
        "first_name": "SHELLY",
        "middle_name": "DAWN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-19",
        "last_updated": "2013-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "R69284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLY",
            "last_name": "LOFTIN",
            "middle_name": "DAWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Briana Kathleen Libey
• LK Goodson Inc
• Iaong Lor, NP
• Joshua Lowe, DO
• Cody Ryan Luker, DC
• Randall Alan Marrs, D.C.
• Brenda Sue Mathis
• Tiffany Kay Matthews, M.ED., CCC-SLP
• Kathleen Mary McGovern, DO
• Medwise LLC

• All providers in Coweta, OK
• Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.