Michelle Shannon Wells, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4496 Issued in OK

Practice address

1111 S Saint Louis Ave
Tulsa, OK 74120-5440

Phone

(918) 619-4600

NPI assigned

May 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family PracticeAlso: General Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Broken Arrow Pain Specialist, LLCGroup PAC ID 2860861390, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northeastern Health System Hospital, Tahlequah, OK, CCN 370089
• Cherokee Nation W W Hastings Indian Hospital Hospital, Tahlequah, OK, CCN 370171

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Broken Arrow Pain Specialist, LLC

  dba Oklahoma Pain Specialist

  • Pain Medicine Physician
  • Tahlequah, OK
  • NPI 1104549427
  Medicare reassignment Care Compare group NPD
• Creek Nation Hospital & Clinics

  dba Creek Nation Health System

  • Clinic/Center
  • Muskogee, OK
  • NPI 1366593923

  Family Medicine

  Medicare reassignment NPD
• Creek Nation Hospital & Clinics

  dba Creek Nation Community Hospital

  • Family Medicine Physician
  • Okemah, OK
  • NPI 1467053173

  TX

  Medicare reassignment NPD
• Homestead Allergy LLC

  dba Homestead Allergy

  • Allergy Physician
  • Bristow, OK
  • NPI 1962892224
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cherokee Nation

  • General Acute Care Hospital
  • Tahlequah, OK
  • NPI 1275799645
  Care Compare affiliation
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Claremore, OK
  • NPI 1497568968

  Hospital

  Care Compare affiliation
• Northeastern Health System

  dba Tahlequah City Hospital

  • General Acute Care Hospital
  • Tahlequah, OK
  • NPI 1003865999
  Care Compare affiliation
• Northeastern Health System

  dba Fort Gibson Medical Clinic

  • Rural Health Clinic/Center
  • Fort Gibson, OK
  • NPI 1013458652

  Hospital

  Care Compare affiliation
• Northeastern Health System

  dba Tahlequah Medical Group Primary Care

  • Rural Health Clinic/Center
  • Tahlequah, OK
  • NPI 1306387949

  Hospital

  Care Compare affiliation
• Northeastern Health System

  • Addiction (Substance Use Disorder) Counselor
  • Tahlequah, OK
  • NPI 1689338519

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699989509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12320 N 177TH EAST AVE",
            "city": "COLLINSVILLE",
            "state": "OK",
            "postal_code": "740216206",
            "telephone_number": "918-625-8146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 S SAINT LOUIS AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741205440",
            "telephone_number": "918-619-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "MICHELLE",
        "middle_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "4496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OSTEOPATHIC BOARD",
            "identifier": "4496",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ethan Wells
• George Caviness Wells
• Joanie Helen Wells, M.S., CCC-SLP
• Kathy Lavonne Wells
• Mekenzei Leighanne Wells
• Tesia D. Wells, PH.D.
• Veronica Lynn Wells, RN CNS
• Frances Kathleen Wen, PHD
• Lauren Elizabeth Wendl, MSW
• Maegan Nicole Wendt

• Family Medicine Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• 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.