Shawn Wall

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

68470 S 315 Rd
Wagoner, OK 74467-6292

Phone

(918) 729-9397

Fax

(918) 482-5136

NPI assigned

Jan 3, 2014

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 3, 2014.

{
    "created_epoch": "1388707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388707200000",
    "number": "1649691908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68470 S 315 RD",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744676292",
            "telephone_number": "918-729-9397",
            "fax_number": "918-482-5136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68470 S 315 RD",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744676292",
            "telephone_number": "918-729-9397",
            "fax_number": "918-482-5136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "SHAWN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-03",
        "last_updated": "2014-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wagoner Hospital Authority
• Wagoner Orthopedic Center
• Wagoner Public Schools
• Wal-Mart Stores East LP
• Walgreen Co
• Mark Walters
• James C Washington
• Samantha Weaver
• Charlei Annette Welch
• Tim A Welch

• All providers in Wagoner, OK
• Addiction (Substance Use Disorder) Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.