FASTCARE MEDICAL CLINIC OF SHAWNEE (NPI# 1336342963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336342963 |
| Entity Type | Organization |
| Organization Name | FASTCARE MEDICAL CLINIC OF SHAWNEE |
| Practice Address |
1605 N Harrison St Shawnee OK 74804-4036 |
| Mailing Address |
Po Box 14587 Oklahoma City OK 73113-0587 |
| Practice Telephone | 4059423737 |
| Practice Fax Number | 4059423873 |
| Mailing Telephone | 4059423737 |
| Mailing Fax Number | 4059423873 |
| Enumeration Date | 2007-06-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DEANNA LOUISE WILLIAMS (DIRECTOR OF BUSINESS DEVELOPMENT) |
| Authorized Official Telephone | 4059423737 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
OK | Ambulatory Health Care Facilities |
| Street Address |
1605 N HARRISON ST |
| City | SHAWNEE |
| State | OK |
| Zip Code | 74804-4036 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891762951 | Brian Ernest Drew | Dentist | 1605 N Harrison St, Shawnee, OK 74804-4022 | 2006-03-07 |
| 1932729092 | Andra Elizabeth Tipton | Counselor | 1605 N Harrison St, Shawnee, OK 74804-4022 | 2020-04-19 |
| 1902464308 | Brittny Rayeann Bradford | Case Manager/Care Coordinator | 1605 N Harrison St, Shawnee, OK 74804-4022 | 2019-05-31 |
| 1427517572 | Shelley L Coffman | Counselor | 1605 N Harrison St, Shawnee, OK 74804-4022 | 2019-03-18 |
| 1992260004 | Juanita Pearl Marshall | Counselor | 1605 N Harrison St, Shawnee, OK 74804-4022 | 2019-02-02 |
| 1124507579 | Amy Adelle Jennings | Counselor | 1605 N Harrison St, Shawnee, OK 74804-4022 | 2018-08-07 |
| 1477060424 | Whitney Rhea Elliott | Case Manager/Care Coordinator | 1605 N Harrison St, Shawnee, OK 74804-4022 | 2017-12-29 |
| 1710402946 | Jennifer Lynn Cheatham | Counselor | 1605 N Harrison St, Shawnee, OK 74804-4022 | 2017-08-09 |
| 1235680984 | Twenty-nine 11, Inc. | Counselor | 1605 N Harrison St, Shawnee, OK 74804-4022 | 2016-10-18 |
| 1184085367 | Twenty-nine 11 Inc | Counselor | 1605 N Harrison St, Shawnee, OK 74804-4022 | 2016-03-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164063699 | Isaac Benjamin Gray | Student in an Organized Health Care Education/Training Program | 4010 Blaine Road, Shawnee, OK 74804 | 2019-10-06 |
| 1750863775 | Dillon Gibson | Specialist/Technologist | Oklahoma Baptist University, 500 W. University, Shawnee, OK 74804 | 2018-09-06 |
| 1912368242 | Peggy Baker | Occupational Therapist | 7602 N. Kickapoo, Shawnee, OK 74804 | 2016-03-15 |
| 1861731093 | Shariff Mohammed El-assi | Behavioral Analyst | 45 Crown Point, Shawnee, OK 74804 | 2013-02-07 |
| 1902103112 | Action Physical Therapy & Rehabilitation, Pllc | Physical Therapist | 2506 N Harrison, Shawnee, OK 74804 | 2011-02-24 |
| 1639493315 | Oklahoma Em - 1 Medical Services,p.c. | Emergency Medicine | 1102 W.macarthur, Shawnee, OK 74804 | 2010-03-24 |
| 1790989473 | Eastern Oklahoma Radiation Associates, LLC | Radiology | 3700 N Kickapoo Ave Ste 108, Shawnee, OK 74804 | 2007-06-14 |
| 1821210444 | Mickey Sehorn D.d.s., P.C. | Dentist | 1601 Airport Drive, Shawnee, OK 74804 | 2007-05-03 |
| 1760525711 | Leanna Rae Olsen | Registered Nurse | 1500 N. Kickapoo, Suite #4, Shawnee, OK 74804 | 2007-02-15 |
| 1467517920 | Mahmoud Abdel-fattah Khalifa | Pathology | Unity Health Center, 1102 West Macarthur, Shawnee, OK 74804 | 2006-12-26 |
| Find all providers in zip 74804 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538358346 | Cindy Rebecca Kelly | Clinic/Center | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2007-10-17 |
| 1932396470 | Lielani M Tull | Clinic/Center | 2307 S Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2007-09-28 |
| 1952597833 | Amanda Kaylene Felkner | Clinic/Center | 2307 S Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2007-09-24 |
| 1104012301 | Aubre Ann Reed | Clinic/Center | 2307 S Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2007-09-20 |
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|---|---|---|---|---|
| 1033759519 | Arabella Medical Spa LLC | Clinic/Center | 701 S Mustang Rd, Yukon, OK 73099-6778 | 2020-01-13 |
| 1245763739 | Essence Massage | Clinic/Center | 782 E Pine St, Tulsa, OK 74106-5925 | 2017-04-11 |
| 1033521430 | The Back Stop LLC | Clinic/Center | 373 S Yukon Pkwy Ste C, Yukon, OK 73099-4597 | 2014-05-20 |
| 1164866737 | Vitality Wellness | Clinic/Center | 5740 Nw 135th St., Oklahoma City, OK 73142 | 2013-04-25 |
| 1881931509 | Wildhorse Family Practice & Urgent Care | Clinic/Center | 1024 W Cherokee, Sallisaw, OK 74955 | 2013-01-15 |
| 1972863041 | Fgg LLC | Clinic/Center | 755 Jenkins Ave, Norman, OK 73069-4951 | 2012-05-23 |
| 1992008072 | Arthritis & Rheumatology Center of Oklahoma | Clinic/Center | 1111 N Lee Ave Ste 249, Oklahoma City, OK 73103-2600 | 2010-12-13 |
| 1598072050 | Health Watch Medical Center | Clinic/Center | 1924 N Portland Ave, Oklahoma City, OK 73107-1532 | 2010-09-04 |
| 1922313972 | Clear Focus Cv Ultrasound Services | Clinic/Center | 502 Oak, Ardmore, OK 73401-3830 | 2010-08-15 |
| 1215172804 | Med-labs LLC | Clinic/Center | 11014 E 51st St, Tulsa, OK 74146-5820 | 2008-12-10 |
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| 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.