Shawnee Medical Center Clinic, Inc.
NPI 1861034779ActiveOrganization· Family Medicine· Seminole, OK
Family Medicine in Seminole, Oklahoma, registered in NPPES in October 2019, part of Ssm Health Care of Oklahoma, Inc. The authorized official on file is Crystal L. Pena, Provider Enrollment/Ins Credential.
Overview
| NPI | 1861034779 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Ssm Health Care of Oklahoma, Inc |
| NPI issued | Oct 11, 2019 |
| Last updated in NPPES | Oct 11, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
| Physician Assistant | 363A00000X | — | — |
| Nurse Practitioner | 363L00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 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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