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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Monday, December 23, 2024 3:49 AM CST
Next Update: Monday, December 23, 2024 12:00 PM CST

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SHRIVASTAVA, RAKESH       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: 105 SOUTH BRYANT AVE
SUITE-101
EDMOND OK 73034

Address last updated on 6/15/2024
Phone #: (405) 622-3063
Fax #: (855) 680-8890
County: OKLAHOMA
License: 27981
Dated: 7/19/2010
Expires: 7/1/2025
License Type: Medical Doctor
Specialty: Internal Medicine
Interventional Cardiology
Cardiovascular Disease
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Inst Of Med Sci, Banaras Hindu Univ, Varanasi, UP, India
Graduated: 6 / 1997
CME Year: 2025
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF INTERNAL MEDICINE - Cardiovascular Disease
AMERICAN BOARD OF INTERNAL MEDICINE - Interventional Cardiology
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: INTEGRIS Baptist Medical Center
Oklahoma City, OK
INTEGRIS Edmond
Edmond, OK
OU Health - Edmond (frmrly Edmond Medical Center)
Edmond, OK
SSM Health St. Anthony Hospital - OKC
Oklahoma City, OK
Locations: Hours: Languages:
105 SOUTH BRYANT AVE
SUITE-101
EDMOND OK 73034

Phone #: (405) 622-3063
Fax #: (855) 680-8890
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
LAUREN CLARK APRN 100056
PAUL WALTER CROWL PA 1006
CAMERON ETHRIDGE APRN 121857
ARNULFO ALEXANDER GARCIA PA 1326
RICHARD DEAN HANES PA 1346
TAYLOR HERNANDEZ APRN 20693
ELIZABETH JACKSON APRN 85963
KRISTIE MCGUIRE APRN 105873
MEGHAN ELIZABETH MOREY PA 4730
KARIS RODRIGUEZ APRN 106928
AUDRIANNA SPARKS APRN 101547
ALAN WAYNE TAYLOR PA 1157
NHANHIEN DUC TRAN PA 1638
MONICA TUBBESING APRN 110487
ROBIN WHITTENBURG APRN 5121

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