NPIMap

Organization Active NPI

Comanche County Healthcare

Doing business as Comanche County Wound Care Center

  • Surgery Physician
  • Lawton, OK
National Provider Identifier
1285651232
Registry record updated Sep 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
22527 Issued in OK
Legal business name
COMANCHE COUNTY HEALTHCARE
Doing business as
Comanche County Wound Care Center
Practice address
2716 W Gore Blvd
Suite C
Lawton, OK 73505
Phone
(580) 357-3280
Fax
(580) 357-7495
NPI assigned
Jul 16, 2006
Last updated
Sep 24, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2013

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

Authorized official

Name
Mr. David Blackmon
Title
Cfo
Phone
(580) 355-8620

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X 22527 OK Primary

Addresses

Primary practice location

2716 W Gore Blvd
Suite C
Lawton, OK 73505

Mailing address

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

Other names 1

  • Comanche County Wound Care Center 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
Tax ID family
Comanche County Healthc34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

Organizations that report the same tax identification number in the National Provider Directory.

View all 33

Locations

1102 S Coblake St
Apache, OK 73006
Phone (580) 588-3257

2716 W Gore Blvd
Ste E
Lawton, OK 73505
Phone (405) 357-1220

3201 W Gore Blvd
Ste 202
Lawton, OK 73505
Phone (580) 248-7872

3201 W Gore Blvd
Ste 301
Lawton, OK 73505
Phone (580) 248-8225

3401 W Gore Blvd
Fl 2
Lawton, OK 73505

4411 W Gore Blvd
Ste Aa
Lawton, OK 73505

4417 W Gore Blvd
Ste 13
Lawton, OK 73505
Phone (580) 248-0404

4645 W Gore Blvd
Ste 4
Lawton, OK 73505

5604 SW Lee Blvd
Ste 210
Lawton, OK 73505
Phone (580) 531-4700

5604 SW Lee Blvd
Ste 257
Lawton, OK 73505
Phone (580) 699-8020

1710 S Broadway St
Marlow, OK 73055

717 S Houston Ave
Tulsa, OK 74127
Phone (918) 382-3178

2800 E Cottonwood Pkwy
Ste 400
Salt Lake City, UT 84121
Phone (385) 478-4518

Practitioners & affiliated clinicians

Practitioners 151

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.

View all 151

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379980800000",
    "number": "1285651232",
    "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": "2716 W GORE BLVD",
            "address_2": "SUITE C",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "73505",
            "telephone_number": "580-357-3280",
            "fax_number": "580-357-7495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMANCHE COUNTY HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2013-09-24",
        "status": "A",
        "authorized_official_last_name": "BLACKMON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "580-355-8620",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "OK",
            "license": "22527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comanche County Wound Care Center",
            "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 Sep 24, 2013; 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.