# SAINT MEDICAL GROUP, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** SSM Health Shawnee Ambulatory Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306447172
- **Authorized official:** SHASTA R MANUEL (VICE PRESIDENT - FINANCE)
- **Authorized official phone:** (405) 272-7282

## Contact information

- **Practice address:** 4651 N HARRISON, SHAWNEE, OK 74804
- **Practice address phone:** (405) 273-5801
- **Practice address fax:** (405) 878-3794
- **Mailing address:** PO BOX 958210, SAINT LOUIS, MO 63195-8210
- **Mailing address phone:** (405) 231-3857
- **Mailing address fax:** (405) 272-7977

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | — | NULL | — |
| 207N00000X | Dermatology Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |

## Other

- **Enumeration date:** 11/06/2020
- **Last updated:** 09/02/2025