Healthcare Provider Details

I. General information

NPI: 1487505038
Provider Name (Legal Business Name): 1ST CHOICE MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 N BELL AVE
SHAWNEE OK
74801-6902
US

IV. Provider business mailing address

120 N BELL AVE
SHAWNEE OK
74801-6902
US

V. Phone/Fax

Practice location:
  • Phone: 405-296-8538
  • Fax: 405-296-8539
Mailing address:
  • Phone: 405-296-8538
  • Fax: 405-296-8539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY JANWAY
Title or Position: CEO
Credential:
Phone: 405-296-8538