NPIMap

Organization Active NPI

Comanche County Healthcare Corporation

Doing business as MMG Allergy and Asthma

  • Allergy & Immunology Physician
  • Lawton, OK
National Provider Identifier
1013640846
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
COMANCHE COUNTY HEALTHCARE CORPORATION
Doing business as
MMG Allergy and Asthma
Practice address
3201 W Gore Blvd Ste 101
Lawton, OK 73505-6350
Phone
(580) 357-9090
Fax
(580) 357-8987
NPI assigned
Jul 8, 2022
Last updated
Aug 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Authorized official

Name
Brent Smith
Title
Ceo
Phone
(580) 585-5522

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X NU Primary

Addresses

Primary practice location

3201 W Gore Blvd Ste 101
Lawton, OK 73505-6350

Mailing address

3401 W Gore Blvd
Lawton, OK 73505-6332

Other names 1

  • MMG Allergy and Asthma Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000742 OK Part B Supplier - Clinic/Group Practice 0749192433 Receives reassigned benefits from 166 practitioners
40 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lawton, OK; Oklahoma City, OK; Pawhuska, OK; Snyder, OK; Tahlequah, OK; The Village, OK; Edmond, OK; Frederick, OK

Other NPIs on the same Medicare enrollment 39

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 39

National Provider Directory

National Provider Directory
Tax ID family
Family Medical Clinic34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

Organizations that report the same tax identification number in the National Provider Directory.

View all 33

Locations

1015 E Broadway St
Ste 104
Altus, OK 73521
Phone (580) 477-1336

3201 W Gore Blvd
Ste 202
Lawton, OK 73505
Phone (580) 248-7872

5604 SW Lee Blvd
Ste 245
Lawton, OK 73505
Phone (580) 531-4845

5606 SW Lee Blvd
Ste 302
Lawton, OK 73505
Phone (580) 531-4750

1318 S Broadway St
#A
Marlow, OK 73055
Phone (580) 658-9100

Practitioners & affiliated clinicians

Practitioners 139

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 139

NPI Registry JSON

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

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691452800000",
    "number": "1013640846",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 W GORE BLVD STE 101",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056350",
            "telephone_number": "580-357-9090",
            "fax_number": "580-357-8987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMANCHE COUNTY HEALTHCARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-08",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "580-585-5522"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MMG Allergy and Asthma",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MMG Allergy and Asthma",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawton, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.