Shirley Chesnut, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2107 Issued in OK

Practice address

10 S. Treaty
Miami, OK 74354-5330

Phone

(918) 542-6644

Fax

(918) 542-6167

NPI assigned

Oct 3, 2006

Last updated

Jun 16, 2009By the provider in NPPES

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 3

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Oklahoma State University College of Osteopathic Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeastern Tribal Health SystemGroup PAC ID 7911893854, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northeastern Tribal Health System

  • Clinic/Center
  • Miami, OK
  • NPI 1871522532

  TX

  Medicare reassignment Care Compare group NPD
• Northeast Oklahoma Clinical Partners, Inc.

  • Clinic/Center
  • Vinita, OK
  • NPI 1902044480
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245110400000",
    "number": "1932293974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 S. TREATY",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "743545330",
            "telephone_number": "918-542-6644",
            "fax_number": "918-542-6167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 S. TREATY",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "743545330",
            "telephone_number": "918-542-6644",
            "fax_number": "918-542-6167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHESNUT",
        "first_name": "SHIRLEY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2009-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "2107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "74354A003",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "74344A010",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100111160A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Cass, LCSW
• Kable Cawyer
• Samantha Hope Cawyer, PTA
• Chauncey B Witcraft MD PC
• Whitney Chavez
• Michelle Elaine Christman, M.A., CCC-SLP
• Audrey Lynn Chubb, RN
• Kimberlee Ann Chuculate
• Carrie Ann Clark, PHARM-D
• Lavon Jo Clark

• Family Medicine Physician in Miami, OK
• Providers in Miami, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; 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.