Shawnee Medical Center Clinic, Inc
NPI 1104462167 · Orthopaedic Surgery Physician · Shawnee, OK
Shawnee Medical Center Clinic, Inc is a Orthopaedic Surgery Physician organization in Shawnee, OK (NPI 1104462167).
Provider details
- NPI number
- 1104462167
- Entity type
- Organization
- Primary specialty
- Orthopaedic Surgery PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Ssm Health Care of Oklahoma, Inc.
- Organization subpart
- Yes
- Authorized official
- Crystal Pena, Credentialing Specialist(405) 272-7452
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Ssm Health Medical Group Shawnee Ortho
Registry dates
- Enumerated
- 2019-11-25
- Last updated
- 2019-11-25
Frequently asked questions
- What is Shawnee Medical Center Clinic, Inc's NPI number?
- Shawnee Medical Center Clinic, Inc's National Provider Identifier (NPI) is 1104462167, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Shawnee Medical Center Clinic, Inc?
- Shawnee Medical Center Clinic, Inc is classified in the NPPES registry as Orthopaedic Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Shawnee Medical Center Clinic, Inc located?
- Shawnee Medical Center Clinic, Inc's practice location on file with NPPES is 3315 Kethley Rd, Shawnee, OK 74804-9638.
- What is Shawnee Medical Center Clinic, Inc's phone number?
- The practice phone number listed in the NPPES registry for Shawnee Medical Center Clinic, Inc is (405) 273-5801.
- Who is the authorized official for Shawnee Medical Center Clinic, Inc?
- The authorized official listed on Shawnee Medical Center Clinic, Inc's NPPES record is Crystal Pena, Credentialing Specialist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Shawnee Medical Center Clinic, Inc's NPI active?
- Yes — Shawnee Medical Center Clinic, Inc's NPI (1104462167) is active in the NPPES registry as of the last update on 2019-11-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.