Shantell Robinson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1415 NW 43Rd St Ste 104
Oklahoma City, OK 73118-5027

Phone

(405) 362-6399

Fax

(580) 215-5764

NPI assigned

Sep 7, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

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.

• Diversity Health and Wellness

  • Internal Medicine Physician
  • Oklahoma City, OK
  • NPI 1790418283

  Health & Wellness Coach

  NPD Authorized official

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671321600000",
    "number": "1750002945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 NW 43RD ST STE 104",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731185027",
            "telephone_number": "405-362-6399",
            "fax_number": "405-444-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 NW 43RD ST STE 104",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731185027",
            "telephone_number": "405-362-6399",
            "fax_number": "580-215-5764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "SHANTELL",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-12-18",
        "certification_date": "2022-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health & Wellness Coach",
            "state": "OK",
            "license": "HFCFRJ2N",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790418283",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750002945",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://chroniccardz.com/",
            "affiliation": "Y",
            "endpointDescription": "APPOINTMENT SCHEDULER",
            "affiliationName": "DIVERSITY HEALTH AND WELLNESS",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ELECTRONIC",
            "address_1": "1415 NW 43rd St Ste 104",
            "city": "Oklahoma City",
            "state": "OK",
            "country_code": "US",
            "postal_code": "731185027",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://diversityhealthandwellness.clientsecure.me/",
            "affiliation": "Y",
            "endpointDescription": "APPOINTMENT SCHEDULER",
            "affiliationName": "DIVERSITY HEALTH AND WELLNESS",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ELECTRONIC",
            "address_1": "1415 NW 43rd St Ste 104",
            "city": "Oklahoma City",
            "state": "OK",
            "country_code": "US",
            "postal_code": "731185027",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://VIRTUALANDWALKINAPPOINTMENTS.as.me/",
            "affiliation": "Y",
            "endpointDescription": "APPOINTMENT SCHEDULER",
            "affiliationName": "DIVERSITY HEALTH AND WELLNESS",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ELECTRONIC",
            "address_1": "1415 NW 43rd St Ste 104",
            "city": "Oklahoma City",
            "state": "OK",
            "country_code": "US",
            "postal_code": "731185027",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "diversityhealthnetwork.com",
            "affiliation": "Y",
            "endpointDescription": "website portal",
            "affiliationName": "DIVERSITY HEALTH AND WELLNESS",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1415 NW 43rd St Ste 104",
            "city": "Oklahoma City",
            "state": "OK",
            "country_code": "US",
            "postal_code": "731185027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Paula Marie Robinson, MA
• Quintina M Robinson
• Rebekah Leigh Robinson, MD
• Regena Robinson
• Robyn Chivonne Robinson
• Shonda Robinson
• Susan Robinson, LPC
• Tremetra M Robinson, M.ED.
• Vicky Robinson, M.S., CCC-SLP
• Wanda Lynn Robinson, PHD, APRN, PMHCNS-BC

• Physician Assistant in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2022; 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.