Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nr Shawnee, LLC

Organization Family Medicine Physician · NPI 1922861004

Nr Shawnee, LLC is a Family Medicine Physician in Shawnee, Oklahoma. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3700 N Kickapoo Ave Ste 116
Shawnee, OK 74804-0007
Phone: (405) 551-8103
Fax: (405) 669-3517
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X
Family Medicine Physician Taxonomy 207Q00000X

Record details

NPI number1922861004
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Timothy Bales — Ceo · (405) 953-7221
Other names Nerve Renewal Shawnee; Nerve Renewal Shawnee
NPI enumeratedFebruary 1, 2024
Last updated in NPPESMarch 3, 2025
Certification dateMarch 3, 2025
Mailing address3705 Nw 63rd St Ste 200, Oklahoma City, OK 73116-1937

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