Rebecca C Shepard, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA1291 Issued in OK

Practice address

402 W Morrow Rd
Sand Springs, OK 74063-6549

Phone

(918) 245-1328

Fax

(918) 293-3181

NPI assigned

Sep 13, 2005

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 2

Other names 1

• Rebecca C Coates Former name

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Omni Medical Group IncGroup PAC ID 9739080490, 82 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St John Medical Center Hospital, Tulsa, OK, CCN 370114
• Ascension St John Sapulpa Hospital, Sapulpa, OK, CCN 371312
• St John Owasso Hospital, Owasso, OK, CCN 370227

Medicare enrollment (NPD)

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.

• Omni Medical Group Inc

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1174578249
  Medicare reassignment Care Compare group
• St. John Physicians, Inc.

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1336194406
  Medicare reassignment NPD (past)
• St. John Physicians, Inc

  • Rural Health Clinic/Center
  • Barnsdall, OK
  • NPI 1033176367
  NPD

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

• Owasso Medical Facility, Inc

  • General Acute Care Hospital
  • Owasso, OK
  • NPI 1144231432
  Care Compare affiliation
• St John Medical Center Inc

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1154417368
  Care Compare affiliation
• St John Medical Center Inc

  • Rehabilitation Hospital Unit
  • Tulsa, OK
  • NPI 1578656161
  Care Compare affiliation
• St John Sapulpa, Inc.

  • Critical Access Hospital
  • Sapulpa, OK
  • NPI 1922076603
  Care Compare affiliation

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389139200000",
    "number": "1922093384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 W MORROW RD",
            "city": "SAND SPRINGS",
            "state": "OK",
            "postal_code": "740636549",
            "telephone_number": "918-245-1328",
            "fax_number": "918-293-3181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W MORROW RD",
            "city": "SAND SPRINGS",
            "state": "OK",
            "postal_code": "740636549",
            "telephone_number": "918-245-1328",
            "fax_number": "918-293-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "REBECCA",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-13",
        "last_updated": "2014-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "PA1291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200024950B",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200024950A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "COATES",
            "middle_name": "C",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sand Springs Primary Eyecare
• Sand Springs School District
• David C Sasser, M.D.
• Charles Kenneth Schmid, DPH
• Rebecca Schulz, CPM
• Tiffany Wemhaner Sibley, D.O.
• Carter Clark Simmons, PHARMD.
• Ashlie Simpson
• Stephanie Sims, CST/CSFA
• Heather Sisson

• Medical Physician Assistant in Sand Springs, OK
• Providers in Sand Springs, OK by specialty
• Medical Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; 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.