MRS. SHANON ELIZABETH PAXSON (NPI# 1376740019) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376740019 |
| Entity Type | Individual |
| Full Name | MRS. SHANON ELIZABETH PAXSON |
| Practice Address |
25322 S 603 Rd Grove OK 74344 |
| Practice Telephone | 9187874368 |
| Mailing Telephone | 9187874368 |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1000670490A | OK | Residential Treatment Facilities |
| X | 347C00000X | Private Vehicle | 1000670490C | OK | Transportation Services |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | OHCA | 1000670490A | 01 |
| OK | OHCA | 1000670490C | 01 |
| Street Address |
25322 S 603 RD |
| City | GROVE |
| State | OK |
| Zip Code | 74344 |
| 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 | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598166803 | Mwindaace Davis | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3304 W Galveston Pl, Broken Arrow, OK 74012-3255 | 2014-09-07 |
| 1467863928 | Independent Nursing | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2113 Ne 2nd St, Moore, OK 73160-8155 | 2014-05-17 |
| 1760782940 | Lxe Counseling Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1100 Quail Rd, Lane, OK 74555 | 2010-10-22 |
| 1386815215 | Cletas Cottage Day Treatment Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 220 South 5th St, Noble, OK 73068 | 2008-03-19 |
| 1225221195 | Muskogee Assoc. for The Rights of Citizens W/developmental Disabled | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 210 E Okmulgee St, Muskogee, OK 74403-5453 | 2007-08-23 |
| 1578760609 | Missy Ann Beets | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 115 N Ethel, Picher, OK 74360 | 2007-07-02 |
| 1609073725 | Vada Arlene Mertens | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 407 16 Blvd Sw, Miami, OK 74354 | 2007-07-02 |
| 1578760203 | Alice Faye Eaglin | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 31850 So 4320 Rd, Big Cabin, OK 74332 | 2007-06-27 |
| 1912104670 | Lori Fay Oneill | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 321 West South Ave, Vinita, OK 74301 | 2007-06-27 |
| 1730385378 | Rachel Bruner | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 27901 W Hwy 16, Bristow, OK 74010 | 2007-06-21 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MRS. SHANON ELIZABETH PAXSON.
| 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.