NPIMap

Organization Active NPI

Comanche County Healthcare Corp

Doing business as MNT Diabetes Services

  • Metabolic Nutrition Registered Dietitian
  • Lawton, OK
National Provider Identifier
1285886713
Registry record updated May 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
Legal business name
COMANCHE COUNTY HEALTHCARE CORP
Doing business as
MNT Diabetes Services
Practice address
3201 W Gore Blvd
Suite 103
Lawton, OK 73505-6378
Phone
(580) 250-6407
Fax
(580) 355-5893
NPI assigned
Oct 15, 2008
Last updated
May 8, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2015

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

Authorized official

Name
Brent Smith
Title
Cfo
Phone
(580) 355-8620

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Metabolic Nutrition Registered Dietitian 133VN1006X NU Primary

Addresses

Primary practice location

3201 W Gore Blvd
Suite 103
Lawton, OK 73505-6378

Mailing address

PO Box 785
Lawton, OK 73502-0785
Phone (580) 357-9984

Other identifiers 1

IdentifierTypeStateIssuer
100810030LMedicaidOK

Other names 1

  • MNT DIABETES SERVICES Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Family Medical Clinic34 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

NPI Registry JSON

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

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431043200000",
    "number": "1285886713",
    "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": "735020785",
            "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": "3201 W GORE BLVD",
            "address_2": "SUITE 103",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056378",
            "telephone_number": "580-250-6407",
            "fax_number": "580-355-5893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMANCHE COUNTY HEALTHCARE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-15",
        "last_updated": "2015-05-08",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "580-355-8620"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100810030L",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MNT DIABETES SERVICES",
            "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 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.