Surgery Center of Lawton Professional LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0030 Issued in OK

Legal business name

SURGERY CENTER OF LAWTON PROFESSIONAL LLC

Practice address

3617 W Gore Blvd
Suite D
Lawton, OK 73505-6373

Phone

(580) 351-0500

Fax

(580) 351-0500

NPI assigned

May 25, 2006

Organization subpart

No

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

Authorized official

Name

Rita Williams

Title

Administrator

Phone

(580) 351-0500

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Listed as

Surgery Center of Lawton Professional LLCCCN 37C0001015

Medicare certification status

ActiveFrom the Provider of Services file

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dale B Smith, DO

  • Otolaryngology Physician
  • Lawton, OK
  • NPI 1083660369
  NPD (past)

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1164478764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3617 W GORE BLVD",
            "address_2": "SUITE D",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056373",
            "telephone_number": "580-351-0500",
            "fax_number": "580-351-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3617 W GORE BLVD",
            "address_2": "SUITE D",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056373",
            "telephone_number": "580-351-0500",
            "fax_number": "580-351-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY CENTER OF LAWTON PROFESSIONAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "RITA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "580-351-0500"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OK",
            "license": "0030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100745750 A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tonya Renee' Sublett
• Suhas D Agte MD PC
• Jay Scott Sullins, D.D.S.
• James Connor Sullivan, AUD
• Sharlenne Sumpter, DDS
• Madissan Marie Sutton
• Richard S Swales, OD
• Alexander Stephen Swan, DO
• Chris Paul Swanson, O.D.
• Daniel Swanson

• Ambulatory Surgical Clinic/Center in Lawton, OK
• Providers in Lawton, OK by specialty
• Ambulatory Surgical Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.