SHAWNEE MEDICAL CENTER CLINIC, INC
NPI 1104462167
Orthopaedic Surgery in Shawnee, OK

Active since November 25, 2019
3315 KETHLEY RD, SHAWNEE, OK 74804(405) 273-5801(405) 878-3794 Get Directions Write a Review

NPPES record last updated: November 25, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shawnee Medical Center Clinic, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHAWNEE MEDICAL CENTER CLINIC, INC (NPI 1104462167), doing business as Ssm Health Medical Group Shawnee Ortho, is a healthcare organization registered as an orthopaedic surgery in Shawnee, Oklahoma and active in the NPI registry since November 2019. The organization lists Crystal L Pena, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1104462167
Entity TypeOrganization
Primary Taxonomy207X00000X
Legal Business NameSHAWNEE MEDICAL CENTER CLINIC, INC
Location Address3315 KETHLEY RDShawnee, OK 74804-9638
Mailing Address3315 Kethley RdShawnee, OK 74804-9638 · (405) 273-5801 · Fax (405) 878-3794
Fax(405) 878-3794
Organization SubpartYesParent: Ssm Health Care Of Oklahoma, Inc.
Authorized OfficialCrystal L PenaCredentialing Specialist · (405) 272-7452
Enumeration DateNovember 25, 2019
NPI 1104462167 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
3315 KETHLEY RD, Shawnee, OK 74804

Other Names 1

Doing Business AsSsm Health Medical Group Shawnee Ortho

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
3315 KETHLEY RD
SHAWNEE, OK 74804
Physician Assistant
3315 KETHLEY RD
SHAWNEE, OK 74804
Surgery
3315 KETHLEY RD
SHAWNEE, OK 74804
Internal Medicine
3315 KETHLEY RD
SHAWNEE, OK 74804
Internal Medicine
3315 KETHLEY RD
SHAWNEE, OK 74804
Family Medicine
3315 KETHLEY RD
SHAWNEE, OK 74804
Pediatrics
3315 KETHLEY RD
SHAWNEE, OK 74804
Physical Therapist
3315 KETHLEY RD
SHAWNEE, OK 74804

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shawnee Medical Center Clinic, Inc's NPI number?

The NPI number for Shawnee Medical Center Clinic, Inc is 1104462167. It was assigned to this organization in the NPPES registry on November 25, 2019. The provider is doing business as SSM Health Medical Group Shawnee Ortho.

Where is Shawnee Medical Center Clinic, Inc located?

Shawnee Medical Center Clinic, Inc is located at 3315 Kethley Rd, Shawnee, OK 74804. The listed phone number is (405) 273-5801.

What is Shawnee Medical Center Clinic, Inc's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

When was this NPI record last updated?

The NPPES record for Shawnee Medical Center Clinic, Inc was last updated on November 25, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.