NPIMap

Organization Active NPI

Comanche County Healthcare

Doing business as MMG Neurosurgery

  • Neurological Surgery Physician
  • Lawton, OK
National Provider Identifier
1083634943
Registry record updated May 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
24442 Issued in OK
Legal business name
COMANCHE COUNTY HEALTHCARE
Doing business as
MMG Neurosurgery
Practice address
110 NW 31St St
2ND Floor
Lawton, OK 73505
Phone
(580) 248-5255
Fax
(580) 248-2036
NPI assigned
Jul 20, 2006
Last updated
May 27, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2016

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

Authorized official

Name
Mr. Brent Smith
Title
Ceo
Phone
(580) 355-8620

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X 24442 OK Primary

Addresses

Primary practice location

110 NW 31St St
2ND Floor
Lawton, OK 73505

Mailing address

PO Box 785
Lawton, OK 73502
Phone (580) 357-9984

Other names 1

  • MMG Neurosurgery 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

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464307200000",
    "number": "1083634943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 785",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "73502",
            "telephone_number": "580-357-9984",
            "fax_number": "580-357-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 NW 31ST ST",
            "address_2": "2ND FLOOR",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "73505",
            "telephone_number": "580-248-5255",
            "fax_number": "580-248-2036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMANCHE COUNTY HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2016-05-27",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "580-355-8620",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": "OK",
            "license": "24442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MMG Neurosurgery",
            "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 May 27, 2016; 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.