Colleen L Gallimore, PAC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

APA1505 Issued in OK

Practice address

3401 W Gore Blvd
Lawton, OK 73505

Phone

(580) 357-4339

Fax

(580) 357-4423

NPI assigned

Jan 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Colleen L Wilson Former name

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Comanche County Healthcare CorporationGroup PAC ID 0749192433, 125 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Health Hospital, Lawton, OK, CCN 370056

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: colleen.gallimore@mmg.eclinicaldirectplus.com

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

• Comanche County Healthcare Corporation

  • Public Health or Welfare Agency
  • Lawton, OK
  • NPI 1053352690
  Medicare reassignment Care Compare group
• Comanche County Healthcare Corporation

  • Allergy & Immunology Physician
  • Lawton, OK
  • NPI 1013640846
  NPD
• Comanche County Healthcare Corporation

  • Otolaryngology Physician
  • Lawton, OK
  • NPI 1609315308
  NPD
• Comanche County Healthcare

  • Surgery Physician
  • Lawton, OK
  • NPI 1285651232
  NPD (past)
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Comanche County Hospital Authority

  • Land Ambulance
  • Walters, OK
  • NPI 1285181610

  Hospital

  Care Compare affiliation
• Comanche County Hospital Authority

  • General Acute Care Hospital
  • Lawton, OK
  • NPI 1720022379
  Care Compare affiliation
• Comanche County Hospital Authority

  • Land Ambulance
  • Lawton, OK
  • NPI 1770525883

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217548800000",
    "number": "1346220415",
    "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": "3401 W GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "73505",
            "telephone_number": "580-357-4339",
            "fax_number": "580-357-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLIMORE",
        "first_name": "COLLEEN",
        "middle_name": "L",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-17",
        "last_updated": "2008-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OK",
            "license": "APA1505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200073860A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "WILSON",
            "middle_name": "L",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Margarette Raquelle Gager
• Jessica Gaines
• Daryl Keith Galindo
• Debra Gallardo, LPC
• Tamyra Gallegos, LPN
• Amber Marie Galloway, PHARM.D.
• Amber L Galvan, RN
• April A Gambrell
• Nathan Gammon, BC-HIS
• Ania Gapeleh, MD

• Surgical Physician Assistant in Lawton, OK
• Providers in Lawton, OK by specialty
• Surgical Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.