NPIMap

Individual provider Active NPI

Shanna Poor Buffalo, APRN, CNP-FAMILY

  • Family Nurse Practitioner
  • Ada, OK
National Provider Identifier
1720430507
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
103544 Issued in OK
Practice address
709 Better Now PLZ
Ada, OK 74820-2279
Phone
(580) 310-9899
Fax
(580) 310-9818
NPI assigned
Jul 6, 2016
Last updated
Sep 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 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 103544 OK Primary

Addresses

Primary practice location

709 Better Now PLZ
Ada, OK 74820-2279

Mailing address

709 Better Now PLZ
Ada, OK 74820-2279
Phone (580) 310-9899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160908000171 TX Practitioner - Nurse Practitioner 2062708654 Reassigns benefits to 1 organization
I20220927003452 OK Practitioner - Nurse Practitioner 2062708654

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wewoka Indian HealthGroup PAC ID 7517911415, 43 clinicians

Practice addresses (Care Compare)

36640 Hwy 270
Wewoka, OK 74884-4021
Phone (405) 257-6282

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wewoka Indian Health CurrentSince Apr 13, 2024 Accepting new patients
Quickcare Aprn-CNP, LLC Family CurrentSince Sep 1, 2022 Accepting new patients

Locations

709 Better Now Plz
Ada, OK 74820
Phone (580) 310-9899

36640 Highway 270
Wewoka, OK 74884
Phone (405) 257-6282

36640 Highway 270
#C
Wewoka, OK 74884
Phone (405) 257-6282

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16230/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1720430507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 BETTER NOW PLZ",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202279",
            "telephone_number": "580-310-9899",
            "fax_number": "580-310-9818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 BETTER NOW PLZ",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202279",
            "telephone_number": "580-310-9899",
            "fax_number": "580-310-9818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOR BUFFALO",
        "first_name": "SHANNA",
        "credential": "APRN, CNP-FAMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-06",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "103544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ada, OK

Sources for this page

Verify at the official NPI Registry.