Active NPI
Robert Lee Ingwerson, LPN
- Licensed Practical Nurse
- Lawton, OK
National Provider Identifier
1053647404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- L0045276
- Practice address
- BLDG. 4300 Mow-Way Rd.
Attn: ICU
Lawton, OK 73503-9042 - Phone
- (580) 558-2600
- NPI assigned
- Oct 20, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | L0045276 | OK | Primary |
Addresses
Primary practice location
BLDG. 4300 Mow-Way Rd.
Attn: ICU
Lawton, OK 73503-9042
Mailing address
4300 NW Wilson St.
Attn: ICU
Fort Sill, OK 73503-9042
Phone (580) 558-2600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L0045276 | OK | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1255996800000",
"number": "1053647404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4300 NW WILSON ST.",
"address_2": "ATTN: ICU",
"city": "FORT SILL",
"state": "OK",
"postal_code": "735039042",
"telephone_number": "580-558-2600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BLDG. 4300 MOW-WAY RD.",
"address_2": "ATTN: ICU",
"city": "LAWTON",
"state": "OK",
"postal_code": "735039042",
"telephone_number": "580-558-2600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INGWERSON",
"first_name": "ROBERT",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-10-20",
"last_updated": "2009-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OK",
"license": "L0045276",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Oct 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.