NPIMap

Individual provider Active NPI

David Allen Hanley, MD

  • Anesthesiology Physician
  • Lawton, OK
National Provider Identifier
1083830715
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
26782 Issued in OK
Practice address
4411 W Gore Blvd Ste A2
Lawton, OK 73505-5977
Phone
(580) 699-8383
Fax
(580) 699-8381
NPI assigned
Apr 18, 2007
Last updated
Mar 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 6303 KS
Anesthesiology Physician 207L00000X 26782 OK Primary
Interventional Pain Medicine Physician 208VP0014X 26782 OK

Addresses

Primary practice location

4411 W Gore Blvd Ste A2
Lawton, OK 73505-5977

Mailing address

4411 W Gore Blvd Ste A2
Lawton, OK 73505-5977
Phone (580) 699-8383

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090820000756 OK Practitioner - AnesthesiologyPractitioner - Pain Management 4284788563 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Red River Medical Services LLCGroup PAC ID 0143651141, 4 clinicians

Practice addresses (Care Compare)

4411 W Gore Blvd
Lawton, OK 73505-5977
Phone (580) 699-8383

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.3 of 100Reported as individual
Quality
99.16
Promoting interoperability
89
Improvement activities
40
Cost
69.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6303KSMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Southwestern Surgical Affiliates, LLC CurrentSince Jul 22, 2019 Accepting new patients
Red River Medical Services LLC CurrentSince Jun 21, 2020 Accepting new patients
Jackson County Memorial Hospital Authority Interventional Pain Medicine Past Accepting new patients
Comanche County Hospital Authority Interventional Pain Medicine Past Accepting new patients
University of Oklahoma Health Scien Ctr Southwest Ok Family Practice Past Accepting new patients
Southwestern Medical Center, LLC Interventional Pain Medicine Past Accepting new patients

Locations

1602 SW 82nd St
Lawton, OK 73505
Phone (580) 536-0077

4411 W Gore Blvd
Ste A2
Lawton, OK 73505
Phone (580) 355-0575

4427 W Gore Blvd
Lawton, OK 73505
Phone (580) 248-2288

5602 SW Lee Blvd
Lawton, OK 73505
Phone (580) 531-4700

5606 SW Lee Blvd
Ste 205
Lawton, OK 73505
Phone (580) 531-6465

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1821/brand/1/csg/22/fhir/r4

Organizations & group practices 6

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

Hospital & facility affiliations 6

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": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1083830715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 W GORE BLVD STE A2",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735055977",
            "telephone_number": "580-699-8383",
            "fax_number": "580-699-8381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 W GORE BLVD STE A2",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735055977",
            "telephone_number": "580-699-8383",
            "fax_number": "580-699-8381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANLEY",
        "first_name": "DAVID",
        "middle_name": "ALLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KS",
            "license": "6303",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "26782",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "OK",
            "license": "26782",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.