SHANNON BRUEY (NPI# 1265985717) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265985717 |
| Entity Type | Individual |
| Full Name | SHANNON BRUEY |
| Practice Address |
1115 Harbor Rd Grove OK 74344-3505 |
| Mailing Address |
1500 N 6th St Ponca City OK 74601-2827 |
| Practice Telephone | 9187864434 |
| Practice Fax Number | 9187864435 |
| Mailing Telephone | 5807636103 |
| Mailing Fax Number | 5807622576 |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2017-05-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163W00000X | Registered Nurse | 96735 | OK | Nursing Service Providers |
| Street Address |
1115 HARBOR RD |
| City | GROVE |
| State | OK |
| Zip Code | 74344-3505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063429181 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 1115 Harbor Rd, Grove, OK 74344-3505 | 2006-08-02 |
| 1669084620 | Deanna M Duvall | Social Worker | 1115 Harbor Rd, Grove, OK 74344-3505 | 2020-08-20 |
| 1558979831 | Amber Rae Coker | Case Manager/Care Coordinator | 1115 Harbor Rd, Grove, OK 74344-3505 | 2020-07-22 |
| 1275157166 | Katharine Jean Downing | Case Manager/Care Coordinator | 1115 Harbor Rd, Grove, OK 74344-3505 | 2020-06-05 |
| 1205464997 | Kristen Bartz | Case Manager/Care Coordinator | 1115 Harbor Rd, Grove, OK 74344-3505 | 2020-03-30 |
| 1144853631 | Jennifer Elizabeth Bowerman | Peer Specialist | 1115 Harbor Rd, Grove, OK 74344-3505 | 2020-02-13 |
| 1427697747 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 1115 Harbor Rd, Grove, OK 74344-3505 | 2020-01-03 |
| 1598302572 | Shelbi Ann Brock | Case Manager/Care Coordinator | 1115 Harbor Rd, Grove, OK 74344-3505 | 2019-12-09 |
| 1447896907 | Jennifer Lynne Andrews | Registered Nurse | 1115 Harbor Rd, Grove, OK 74344-3505 | 2019-11-20 |
| 1497399331 | Steven Graham Shackelford | Case Manager/Care Coordinator | 1115 Harbor Rd, Grove, OK 74344-3505 | 2019-11-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326604935 | Deborah Stauss | Massage Therapist | 2086 S Main St, Grove, OK 74344 | 2019-05-20 |
| 1841776705 | Progressive Orthotic & Prosthetic Services, Inc | Prosthetic/Orthotic Supplier | 10 E 6th St., Grove, OK 74344 | 2018-07-13 |
| 1205329232 | Andra Renee Mitchell | Speech-Language Pathologist | 825 E Third Street, Grove, OK 74344 | 2018-06-13 |
| 1861996217 | Jenniffer Colleen Clark I | Case Manager/Care Coordinator | 1115 Har-ber Rd, Grove, OK 74344 | 2018-03-21 |
| 1417458167 | Jason S Beckham | Case Manager/Care Coordinator | 32600 S. 625 Road, Grove, OK 74344 | 2018-02-27 |
| 1659872034 | Keli Elaine Whitlock | Peer Specialist | 5602 Us Hwy 59, Grove, OK 74344 | 2018-02-22 |
| 1851899454 | Nichole Marie Wooton | Case Manager/Care Coordinator | 1115 Har-ber Road, Grove, OK 74344 | 2018-01-29 |
| 1043766645 | Samantha Lane | Speech-Language Pathologist | 1046 Hillside Road, Grove, OK 74344 | 2016-09-01 |
| 1376927509 | Matthew Kyle Allen | Physical Therapy Assistant | 4621 Hwy 59 N, Grove, OK 74344 | 2015-07-17 |
| 1477807428 | Andrew Scott Littlejohn | Physical Therapy Assistant | 103 Harber Road, Grove, OK 74344 | 2012-10-30 |
| Find all providers in zip 74344 | ||||
| Taxonomy Code | 163W00000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.’s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span. |
| Notes: Sources: (2) American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356829352 | Kimberly Rene Buffalo | Registered Nurse | 414 E 3rd St Ste C, Grove, OK 74344-7130 | 2018-08-01 |
| 1104326735 | Libby Sarwinski | Registered Nurse | 1115 S. Harber Road, Grove, OK 74344-7918 | 2018-02-20 |
| 1447896907 | Jennifer Lynne Andrews | Registered Nurse | 1115 Harbor Rd, Grove, OK 74344-3505 | 2019-11-20 |
| 1407353261 | Amanda Rumple | Registered Nurse | 1115 Harbor Rd, Grove, OK 74344-3505 | 2018-04-09 |
| 1043726706 | Jaquelynn Jean Wood | Registered Nurse | 1115 Harbor Rd, Grove, OK 74344-3505 | 2017-12-18 |
| 1255790002 | Pamela Sue Johnson | Registered Nurse | 1115 Harbor Rd, Grove, OK 74344-3505 | 2016-02-22 |
| 1528496627 | Beverly Helms | Registered Nurse | 5 E 14th St, Grand Prosthetics Lightweight Artificial Limbs, Grove, OK 74344-5347 | 2013-10-29 |
| 1356570204 | Rachel Lynn Bryant | Registered Nurse | 1115 Harbor Rd, Grove, OK 74344-3505 | 2009-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336740786 | Jennifer Lynn Black | Registered Nurse | 24919 S 4420 Road, Vinita, OK 74301 | 2020-11-03 |
| 1003414459 | Valerie Lynn Upshaw | Registered Nurse | 2724 W 68th St, Tulsa, OK 74132-1748 | 2020-10-16 |
| 1174121248 | Rhonda Jo Deramus | Registered Nurse | 312 W Deramus Ln, Broken Bow, OK 74728-6102 | 2020-10-12 |
| 1629685078 | Sherifat Omobola Raimi | Registered Nurse | 8809 Nw 84th St, Oklahoma City, OK 73132-4058 | 2020-09-29 |
| 1679180699 | Whitney Michelle Simmons | Registered Nurse | 2109 Silver Fox Dr, Edmond, OK 73003-6231 | 2020-09-24 |
| 1508479304 | Angela Renee Gunn | Registered Nurse | 35620 Ew 1260, Seminole, OK 74868-6903 | 2020-08-31 |
| 1285245258 | Katherine M Morgan | Registered Nurse | 4731 Judy Dr, Del City, OK 73115-3815 | 2020-08-13 |
| 1437768561 | Darrin Lashae Rupp | Registered Nurse | 1624 E Cimarron Dr, Stillwater, OK 74075-7304 | 2020-07-24 |
| 1447868849 | Cammie Ladawn Wyckoff | Registered Nurse | 1500 Cookson Dr, Ponca City, OK 74604-4109 | 2020-07-21 |
| 1952929515 | Tasha Shea Smith | Registered Nurse | 2225 N. Union, Ponca City, OK 74601-1536 | 2020-07-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.