Individual provider Active NPI

Shymol A John, APRN, CNP

  • Family Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1679115703
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
99974 Issued in OK
Practice address
525 SW 80TH St
Ste 200
Oklahoma City, OK 73139-9405
Phone
(405) 631-0481
Fax
(405) 631-9025
NPI assigned
Oct 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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 99974 OK Primary

Addresses

Primary practice location

525 SW 80TH St
Ste 200
Oklahoma City, OK 73139-9405

Mailing address

525 SW 80TH St
Ste 200
Oklahoma City, OK 73139-9405
Phone (405) 601-8980

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
I20210407000066 OK Practitioner - Nurse Practitioner 3779990973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

4205 McAuley Blvd
Suite 375
Oklahoma City, OK 73120-9309
Phone (405) 751-4343

Hospital & facility affiliations

  • Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013
  • Mercy Hospital Logan County Hospital, Guthrie, OK, CCN 371317

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
99974OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Oklahoma Communities CurrentSince Sep 1, 2023 Accepting new patients
Southwest Gastroenterology Associates PLLC CurrentSince Jun 20, 2022 Accepting new patients
Summit Medical Center Past Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients

Locations

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

4205 McAuley Blvd
Ste 375
Oklahoma City, OK 73120
Phone (405) 749-4247

525 SW 80th St
Ste 200
Oklahoma City, OK 73139
Phone (405) 601-8980

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1570579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1679115703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 SW 80TH ST",
            "address_2": "STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731399405",
            "telephone_number": "405-601-8980",
            "fax_number": "405-631-9025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 SW 80TH ST",
            "address_2": "STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731399405",
            "telephone_number": "405-631-0481",
            "fax_number": "405-631-9025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "SHYMOL",
        "middle_name": "A",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-09",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "99974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.