SHAWN FADUM (NPI# 1013374271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013374271 |
| Entity Type | Individual |
| Full Name | SHAWN FADUM |
| Credential | PA |
| Practice Address |
1104 Walnut Dr Ardmore OK 73401-2353 |
| Practice Telephone | 5802260543 |
| Practice Fax Number | 5802262284 |
| Mailing Telephone | (580) 226-0543 |
| Mailing Fax Number | 5802262284 |
| Enumeration Date | 2016-01-19 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
2640 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1306 12th Ave Nw, Ardmore, OK 734011285 | 5802236004 |
| Street Address |
1104 WALNUT DR |
| City | ARDMORE |
| State | OK |
| Zip Code | 73401-2353 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770504037 | Miguel Antonio Camacho-garrido | Pediatrics | 1104 Walnut Dr, Ardmore, OK 73401-2353 | 2006-07-22 |
| 1346618980 | Family Health Skilled Services LLC | Family Medicine | 1104 Walnut Dr, Ardmore, OK 73401-2353 | 2015-09-14 |
| 1952476251 | Osu Center for Health Sciences | Clinic/Center | 1104 Walnut Dr, Ardmore, OK 73401-2353 | 2006-11-21 |
| 1497853774 | Melissa Cashman, Ph.d.,p.c.,inc. | Psychologist | 1104 Walnut Dr, Ardmore, OK 73401-2353 | 2006-09-20 |
| 1871698514 | Melissa Cashman | Psychologist | 1104 Walnut Dr, Ardmore, OK 73401-2353 | 2006-09-14 |
| 1497862304 | Miguel A. Camacho, Md P.C. | Pediatrics | 1104 Walnut Dr, Ardmore, OK 73401-2353 | 2006-08-24 |
| 1871607903 | Michael W Carnahan | Family Medicine | 1104 Walnut Dr, Ardmore, OK 73401-2353 | 2006-08-18 |
| 1568576619 | Family Practice Associates | Family Medicine | 1104 Walnut Dr, Ardmore, OK 73401-2353 | 2006-08-18 |
| 1972616183 | Sharon E Hall | Nurse Practitioner | 1104 Walnut Dr, Ardmore, OK 73401-2353 | 2006-08-15 |
| 1407879661 | Thomas W Mcculloh | Family Medicine | 1104 Walnut Dr, Ardmore, OK 73401-2353 | 2006-07-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497391452 | Abbie Deeann Mclemore | Nurse Practitioner | 915 10th Ave, Ardmore, OK 73401 | 2019-11-25 |
| 1790349991 | Shirley Denise Brown | Licensed Psychiatric Technician | 1219 Kst N.w, 1219 Kst N.w, Ardmore, OK 73401 | 2019-04-24 |
| 1427512359 | Billy Joe Oshields | Case Manager/Care Coordinator | 6862 State Hwy 199 Ardmore Oklahoma, 6862 State Hwy 199, Ardmore, OK 73401 | 2019-01-24 |
| 1174007595 | Tawnya Dawn Peery | Nurse Practitioner | 1108 W. Walnut Drive, Ardmore, OK 73401 | 2018-09-21 |
| 1679055016 | Teresa Marie Hernandez | Behavior Technician | 1219 K St. Nw, Ardmore, OK 73401 | 2018-09-01 |
| 1063991974 | Sawyer Rae Shamburger | Occupational Therapy Assistant | 208 North Praire St, Pilot Point, TX 73401 | 2018-08-10 |
| 1417473521 | Chelsye Bacon | Peer Specialist | 905 Holiday Drive, Ardmore, OK 73401 | 2017-08-21 |
| 1003279746 | Jeni Presley | Marriage & Family Therapist | Outpatient Services-ardmore; 2510 Chickasaw Dr., Strong Family Development;, Ardmore, OK 73401 | 2016-03-31 |
| 1982080909 | Alison Hill | Pharmacist | 1111 N. Commerce, Ardmore, OK 73401 | 2015-07-31 |
| 1316346547 | Olivia Larae Carrell | Counselor | 15 Monroe Street Ne, Ardmore, OK 73401 | 2014-08-13 |
| Find all providers in zip 73401 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386283679 | Cody Rice Chambers | Physician Assistant | 2002 12th Ave Nw Ste B, Ardmore, OK 73401-1206 | 2020-01-03 |
| 1013288687 | Rhea Michelle Buycks | Physician Assistant | 317 N Rockford Rd, Ardmore, OK 73401-2552 | 2012-01-13 |
| 1972901650 | Keith Vincent Mcinnerney | Physician Assistant | 908 N Rockford Rd, Suite A, Ardmore, OK 73401-2540 | 2014-12-12 |
| 1427335348 | Scott Allen Cooper | Physician Assistant | 731 12th Ave Nw, Ardmore, OK 73401-5761 | 2011-11-06 |
| 1316250418 | Barbara Michelle Chapman | Physician Assistant | 908 N Rockford Rd, Ardmore, OK 73401-2540 | 2010-07-17 |
| 1285713065 | Megan Catherine Hoffield | Physician Assistant | 2410 N Commerce St, Ardmore, OK 73401-1356 | 2006-11-03 |
| 1760561351 | John Thomas Paul | Physician Assistant | 2002 12th Ave Nw, Suite B, Ardmore, OK 73401-1206 | 2006-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790392868 | James Scott Turner | Physician Assistant | 924 Nw 14th St, Moore, OK 73160-1610 | 2020-09-23 |
| 1073154647 | Haley Nicole Beaird | Physician Assistant | 8907 E 93rd St, Tulsa, OK 74133-5634 | 2019-10-03 |
| 1568920924 | Direct2u Urgent Care Pllc | Physician Assistant | 2417 County Road 1263, Blanchard, OK 73010-3123 | 2019-03-05 |
| 1538625660 | Symachia LLC | Physician Assistant | 115 N. Main St., Cashion, OK 73106 | 2019-02-13 |
| 1982172029 | William Landon Ross | Physician Assistant | 3705 W Memorial Rd Ste 101, Oklahoma City, OK 73134-1508 | 2018-11-07 |
| 1639646656 | Jacob Allbritton | Physician Assistant | 10824 Admiral Dr, Oklahoma City, OK 73162-6843 | 2018-10-29 |
| 1316420086 | Lauren Anto | Physician Assistant | 2824 Classen Blvd Ste 100, Norman, OK 73071-4059 | 2018-09-10 |
| 1073004768 | Shelby Teel | Physician Assistant | 1200 Everett Dr # 8305, Oklahoma City, OK 73104-5047 | 2018-05-29 |
| 1093240749 | Green's Country Clinic, LLC | Physician Assistant | 223 E Blackwell Ave, Blackwell, OK 74631-2909 | 2017-05-01 |
| 1255871349 | Michele Starr | Physician Assistant | 409 Nw 39th St, Oklahoma City, OK 73118-8415 | 2017-03-08 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SHAWN FADUM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.