Shamrock, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

SHAMROCK, INC

Doing business as

Medical Equipment Affilitates

Practice address

200 W Choctaw St
Tahlequah, OK 74464-3369

Phone

(918) 456-4797

Fax

(918) 456-8413

NPI assigned

Sep 29, 2006

Organization subpart

Yes

Parent organization

WACUKA INCAs reported in NPPES

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

Authorized official

Name

Randy M Taylor

Title

Ceo/President

Phone

(918) 456-4797

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Medical Equipment Affilitates Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687737600000",
    "number": "1699867549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W CHOCTAW ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643808",
            "telephone_number": "918-456-4797",
            "fax_number": "918-456-8413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W CHOCTAW ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643369",
            "telephone_number": "918-456-4797",
            "fax_number": "918-456-8413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAMROCK, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WACUKA INC",
        "enumeration_date": "2006-09-29",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "918-456-4797"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100809610A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Equipment Affilitates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medical Equipment Affilitates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James Mark Seratt, MD
• Jakkie Sevier, OTR/L
• Ashley Cheyenne Sevilla
• Michelle Renee Shade
• Steven Anderson Shade
• Cindy Xinyun Shan, OD
• Shana Netherlain Davis
• Patrick Wayne Sharp, DO
• Shannon Dee Ann Sharp
• Abigail Shaw

• Durable Medical Equipment & Medical Supplies in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Durable Medical Equipment & Medical Supplies in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.