NPIMap

Individual provider Active NPI

Danna K Stuart, MD

  • Family Medicine Physician
  • Shattuck, OK
National Provider Identifier
1891716775
Registry record updated Jan 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
24874 Issued in OK
Practice address
404 South Main Street
Shattuck, OK 73858
Phone
(580) 938-5400
Fax
(580) 938-5409
NPI assigned
Jul 23, 2006
Last updated
Jan 8, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 24874 OK Primary

Addresses

Primary practice location

404 South Main Street
Shattuck, OK 73858

Mailing address

PO Box 827
Shattuck, OK 73858-0827
Phone (580) 938-5400

Other identifiers 1

IdentifierTypeStateIssuer
200093290AMedicaidOK

Other names 1

  • Dr. Danna K Dersch Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060809000413 OK Practitioner - Family Practice 4981633492 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Newman Memorial Hospital, IncGroup PAC ID 2567482367, 29 clinicians

Practice addresses (Care Compare)

1000 15TH St
Woodward, OK 73801-3008
Phone (580) 571-3160

905 S Main
Shattuck, OK 73858-9205

905 S Main St
Shattuck, OK 73858-9205
Phone (580) 938-2551

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Newman Memorial Hospital, Inc. Past Accepting new patients
Summit Medical Center Past Accepting new patients
Shattuck Nursing Center Inc PastSince Jan 1, 2020 Accepting new patients
Newman Memorial Hospital, Inc Family Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dstuart67086@direct-ehr-ssmhc.com

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Newman Memorial Hospital, IncShattuck, OK, CCN 37Z336 Hospital Corporate Director Aug 1, 2006
Newman Memorial Hospital, IncShattuck, OK, CCN 371336 Hospital Corporate Director Aug 1, 2006
Shattuck Nursing Center IncShattuck, OK, CCN 375564 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2020
Jan 1, 2020
Newman Healthcare AssociatesShattuck, OK, CCN 378533 Rural health clinic Operational/Managerial Control Jun 11, 2019
Newman Healthcare Associates WoodwardWoodward, OK, CCN 378563 Rural health clinic W-2 Managing Employee Jan 1, 2025

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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 10

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": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357603200000",
    "number": "1891716775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 827",
            "city": "SHATTUCK",
            "state": "OK",
            "postal_code": "738580827",
            "telephone_number": "580-938-5400",
            "fax_number": "580-938-5409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 SOUTH MAIN STREET",
            "city": "SHATTUCK",
            "state": "OK",
            "postal_code": "73858",
            "telephone_number": "580-938-5400",
            "fax_number": "580-938-5409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUART",
        "first_name": "DANNA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-23",
        "last_updated": "2013-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "24874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200093290A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANNA",
            "last_name": "DERSCH",
            "middle_name": "K",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Shattuck, OK

Sources for this page

Verify at the official NPI Registry.