Individual provider Active NPI

Shawn Dave, MD

  • Family Medicine Physician
  • Lawton, OK
National Provider Identifier
1003475328
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34811 Issued in OK
Practice address
1202 NW Arlington Ave
Lawton, OK 73507-6537
Phone
(580) 248-2288
Fax
(580) 699-3316
NPI assigned
Jun 10, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 34811 OK Primary

Addresses

Primary practice location

1202 NW Arlington Ave
Lawton, OK 73507-6537

Mailing address

3401 W Gore Blvd
Lawton, OK 73505-6332
Phone (580) 355-8620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240729000423 OK Practitioner - Family Practice 0547706343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comanche County Hospital AuthorityGroup PAC ID 2668373689, 54 clinicians

Practice addresses (Care Compare)

3401 W Gore Blvd
Lawton, OK 73505-6332

5404 SW Lee Blvd
Lawton, OK 73505-9521
Phone (580) 355-5242

Hospital & facility affiliations

  • Elara Caring Xxiv Home health agency, Lawton, OK, CCN 377660
  • Complete Home Health of Tishomingo LLC Home health agency, Tishomingo, OK, CCN 377704
  • Memorial Health Hospital, Lawton, OK, CCN 370056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Comanche County Hospital Authority CurrentSince Aug 5, 2024 Accepting new patients
Comanche County Hospital Authority CurrentSince Aug 5, 2024 Accepting new patients
Comanche County Hospital Authority Past Accepting new patients
Comanche County Healthcare Past Accepting new patients

Locations

5404 SW Lee Blvd
Lawton, OK 73505
Phone (580) 355-5242

3811 W Gore Blvd
Lawton, OK 73505
Phone (580) 581-1500

1202 NW Arlington Ave
Lawton, OK 73507
Phone (580) 248-2288

3401 W Gore Blvd
Lawton, OK 73505
Phone (580) 483-5207

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AGIFAA/Endpoint/AGIFAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/AGIFAA
  • Direct secure messaging: shawn.dave@lawtoncommunityhealthcenter.eclinicaldirectplus.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1003475328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 W GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056332",
            "telephone_number": "580-355-8620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 NW ARLINGTON AVE",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735076537",
            "telephone_number": "580-248-2288",
            "fax_number": "580-699-3316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVE",
        "first_name": "SHAWN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-10",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "34811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.