Holly Nicole Shinnen, P.A.
Individual provider Active NPI Physician Assistant · Bristow, OK
NPI 1891991576 · NPPES record last updated Nov 13, 2023
Key facts
- NPI
- 1891991576
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 1517 (OK)
- Practice address
- 519 N Main St Ste 102
Bristow, OK 74010-2016 - Phone
- (918) 367-6611
- Fax
- (918) 367-9915
- NPI assigned
- Jun 21, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Warren Clinic Inc
Practice addresses (Care Compare)
6600 S Yale Ave
Suite 1400
Tulsa, OK 74136-3331
Phone (918) 488-6000
Hospital & facility affiliations
- Enhabit Home Health of Northeast Oklahoma
- Saint Francis Hospital, Inc
- Saint Francis Hospital South, LLC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071030000501 | OK | Practitioner - Physician Assistant | 2961599410 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1517 | OK | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Warren Clinic Inc | Current |
Accepting new patients | |
| Saint Francis Hospital, Inc. | Past | Accepting new patients | |
| Urgent Care of Green Country PLLC | Past | Accepting new patients | |
| Summit Medical Center | Past | Accepting new patients | |
| Urgent Care of Green Country PLLC | Past | Accepting new patients |
Locations
519 N Main St
Ste 102
Bristow, OK 74010
Phone (918) 367-6611
700 W 7th Ave
Ste 6
Bristow, OK 74010
Phone (918) 367-2215
700 W 7th Ave
Bristow, OK 74010
Phone (918) 367-2215
519 N Main St
Bristow, OK 74010
Phone (918) 367-1444
6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045
6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125
Interoperability endpoints
- hshinnen303768@direct.saintfrancis.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1517 | OK | Yes |
Addresses
Primary practice location
519 N Main St Ste 102
Bristow, OK 74010-2016
Mailing address
6600 S Yale Ave Ste 1400
Tulsa, OK 74136-3331
Phone (888) 247-0125
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200225650A | Medicaid | OK | |
| P01099343 | Other | OK | MEDICARE RAILROAD |
Other providers in Bristow, OK
- Scott Russell
- Ryan Charles Rychel
- Saint Francis Outreach Services LLC
- Richard Wright Schafer
- Joanne Schroer
- Matthew Shockley
- Angela D Skousen
- Carl Roe Smith
- Snyder Medical Clinic
- Ryleigh Spencer
All providers in Bristow, OK · Physician Assistant in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.