Shawnee Medical Center Clinic, Inc
NPI 1104462167ActiveOrganization· Orthopaedic Surgery· Shawnee, OK
Orthopaedic Surgery in Shawnee, Oklahoma, registered in NPPES in November 2019, part of Ssm Health Care of Oklahoma, Inc. The authorized official on file is Crystal L. Pena, Credentialing Specialist.
Overview
| NPI | 1104462167 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Ssm Health Care of Oklahoma, Inc. |
| NPI issued | Nov 25, 2019 |
| Last updated in NPPES | Nov 25, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Orthopaedic Surgery Primary | 207X00000X | — | — |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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