Individual provider Active NPI

Alicia Ortiz, DNP, NP-C

  • Family Nurse Practitioner
  • Lawton, OK
National Provider Identifier
1043095268
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
219040 Issued in OK
Practice address
3201 W Gore Blvd Ste 203
Lawton, OK 73505-6350
Phone
(580) 250-6540
Fax
(580) 354-5937
NPI assigned
Aug 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R0136309 OK
Family Nurse Practitioner 363LF0000X 219040 OK Primary

Addresses

Primary practice location

3201 W Gore Blvd Ste 203
Lawton, OK 73505-6350

Mailing address

3201 W Gore Blvd
Lawton, OK 73505-6378
Phone (580) 250-6540

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240912003652 OK Practitioner - Nurse Practitioner 0749720001 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R0136309OKMDRegistered Nurse
219040OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comanche County Hospital Authority CurrentSince Sep 9, 2024 Accepting new patients
Comanche County Hospital Authority CurrentSince Sep 9, 2024 Accepting new patients
Comanche County Hospital Authority Past Accepting new patients
Comanche County Healthcare Past Accepting new patients

Locations

512 SW Lee Blvd
Lawton, OK 73501
Phone (580) 250-6541

3201 W Gore Blvd
Ste 203
Lawton, OK 73505
Phone (580) 250-6540

2609 SW Lee Blvd
Lawton, OK 73505
Phone (580) 248-5242

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

3201 W Gore Blvd
Lawton, OK 73505
Phone (580) 250-5385

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

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1043095268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 W GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056378",
            "telephone_number": "580-250-6540",
            "fax_number": "580-354-5937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 W GORE BLVD STE 203",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056350",
            "telephone_number": "580-250-6540",
            "fax_number": "580-354-5937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "ALICIA",
        "credential": "DNP, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-28",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "R0136309",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "219040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.