Shannon J Medley (NPI# 1376705806, PAC ID# 9133012529) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1376705806 |
| PAC ID by PECOS | 9133012529 |
| Professional Enrollment ID | I20100122000219 |
| Full Name | Shannon J Medley |
| Organization Legal Name | MERCY CLINIC OKLAHOMA COMMUNITIES |
| Address |
1208 W 15th St Edmond OK 73013-3001 |
| Phone Number | 4053402100 |
| Gender | F |
| Credential | MNT |
| Medical School | UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE |
| Graduation Year | 2006 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 1153468921 |
| Number of Group Practice Members | 451 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 370013 | MERCY HOSPITAL OKLAHOMA CITY, INC |
| 370093 | OU MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1208 W 15th St, Edmond, OK 73013-3001 | 4053402100 | MERCY CLINIC OKLAHOMA COMMUNITIES |
| 416 W 15th St, Bldg 200, Edmond, OK 73013-3666 | 4054716611 | MERCY CLINIC OKLAHOMA COMMUNITIES |
| 4300 W Memorial Rd, Mercy Health Center, Oklahoma City, OK 73120-8304 | 4057551515 | MERCY CLINIC OKLAHOMA COMMUNITIES |
| Organization Legal Name | MERCY CLINIC OKLAHOMA COMMUNITIES |
| Physicians | 496 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ramsha Saleem | Internal Medicine | Mercy Clinic Oklahoma Communities | 520 N Monte Vista St A, Mercy Clinic, Ada, OK 74820-4674 |
| Kyle R Judkins | Family Medicine | Mercy Clinic Oklahoma Communities | 1060 Sw 4th St, Moore, OK 73160-2494 |
| Peter Louis Tran | Nurse Practitioner | Mercy Clinic Oklahoma Communities | 4505 Memorial Cir, Oklahoma City, OK 73142-5004 |
| Kimberly Litton Peck | Clinical Social Worker | Mercy Clinic Oklahoma Communities | 14001 Mcauley Blvd, Suite 200, Oklahoma City, OK 73134-7004 |
| Julie M Shelley | Family Practice | Mercy Clinic Oklahoma Communities | 2601 Sw 119th St, Oklahoma City, OK 73170-2625 |
| Jamilia Lashawn Broussard | Nurse Practitioner | Mercy Clinic Oklahoma Communities | 1001 12th Nw Ave, Mercy Clinic, Ardmore, OK 73401-5712 |
| Henry Le | Internal Medicine | Mercy Clinic Oklahoma Communities | 2115 Parkview Dr, El Reno, OK 73036-2109 |
| Christopher Michael Henry | Internal Medicine | Mercy Clinic Oklahoma Communities | 13313 N Meridian Ave D, Mercy Clinic, Oklahoma City, OK 73120-8316 |
| Dekoda Kole Bost | Family Medicine | Mercy Clinic Oklahoma Communities | 11900 Nw Expressway, Yukon, OK 73099-8795 |
| Sneha Pranjal Desai | Obstetrics/gynecology | Mercy Clinic Oklahoma Communities | 1020 N Commerce St, Mercy Clinic Primary Care Commerce, Ardmore, OK 73401-3920 |
| Street Address |
1208 W 15TH ST |
| City | EDMOND |
| State | OK |
| Zip | 73013-3001 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Frank C Davis | Family Medicine | Mercy Clinic Oklahoma Communities | 1208 W 15th St, Edmond, OK 73013-3001 |
| Taylor L Beaird | Physician Assistant | Mercy Clinic Oklahoma Communities | 1208 W 15th St, Edmond, OK 73013-3001 |
| Erin C Yarborough | Physician Assistant | Mercy Clinic Oklahoma Communities | 1208 W 15th St, Edmond, OK 73013-3001 |
| James M Jang | Family Medicine | Mercy Clinic Oklahoma Communities | 1208 W 15th St, Edmond, OK 73013-3001 |
| Terrill D Hulson | Family Medicine | Mercy Clinic Oklahoma Communities | 1208 W 15th St, Edmond, OK 73013-3001 |
| Jerimiah Capen Johnson | Family Medicine | Mercy Clinic Oklahoma Communities | 1208 W 15th St, Edmond, OK 73013-3001 |
| Courtney W Hammond | Nurse Practitioner | Mercy Clinic Oklahoma Communities | 1208 W 15th St, Edmond, OK 73013-3001 |
| Christina Hiersche | Physician Assistant | Mercy Clinic Oklahoma Communities | 1208 W 15th St, Edmond, OK 73013-3001 |
| Craig R Evans | Family Practice | Mercy Clinic Oklahoma Communities | 1208 W 15th St, Edmond, OK 73013-3001 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Senthil K Raju | Family Medicine | 11824 Slash Pine Dr, Edmond, OK 73013-0462 | |
| Dinah S Cloud | Psychologist, Clinical | 929 Nw 164th St, Suite 111, Edmond, OK 73013-1002 | |
| Lori A Fredrick | Diagnostic Radiology | Board of Regents of The University of Oklahoma - Ou Physicians | 14101 N Eastern Ave, Ou Physicians At Edmond, Edmond, OK 73013-1039 |
| Joseph Davey | Orthopedic Surgery | Board of Regents of The University of Oklahoma - Ou Physicians | 14101 N Eastern Ave, Ou Physicians At Edmond, Edmond, OK 73013-1039 |
| Sara Kathleen Watson | Family Medicine | Board of Regents of The University of Oklahoma - Ou Physicians | 14101 N Eastern Ave, Ou Physicians At Edmond, Edmond, OK 73013-1039 |
| Neadum B Odum | Chiropractic | 15100 Traditions Blvd, Suite 1, Edmond, OK 73013-1184 | |
| Ashley D Mathias | Nurse Practitioner | James Avery Rush Iv Md Pa | 15205 Traditions Lake Pkwy, Edmond, OK 73013-1198 |
| Tanya M Rennie | Nurse Practitioner | James Avery Rush Iv Md Pa | 15205 Traditions Lake Pkwy, Edmond, OK 73013-1198 |
| Michael Daniel Spieker | Nurse Practitioner | James Avery Rush Iv Md Pa | 15205 Traditions Lake Pkwy, Edmond, OK 73013-1198 |
| Amer B Nouh | Neurology | 1417 Nw 150th St, Neuro Pain Care, Edmond, OK 73013-1305 | |
| Find all physicians in zip 73013 | |||
| City | EDMOND |
| Zip Code | 73013 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | EDMOND + PHYSICIAN ASSISTANT |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.