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

Mrs. Shannon Whitney Clark, PHYSICIANASSISTANT

Individual provider Medical Physician Assistant · NPI 1811569270

Mrs. Shannon Whitney Clark, PHYSICIANASSISTANT is a Physician Assistant in Enid, Oklahoma. Qualified in 2021, 5 years ago. Practices with Oliver Street 5 01(A) Inc, a 168-clinician group and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
5
Licensed in
OK
In the registry since
2021
Specialties on file
2

Practice location Address checks out

600 S Monroe St
Enid, OK 73701-7211
Phone: (580) 233-2300
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 4606 (OK)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 4606 (OK)

Record details

NPI number1811569270
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedJuly 14, 2021
Last updated in NPPESSeptember 30, 2021
Certification dateSeptember 30, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Oliver Street 5.01(A) Inc — 168 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Enid