NPIMap

Organization Active NPI

Comanche County Hospital Authority

Doing business as LCHC Primary Health Care Center at Comanche County Memorial Hospital

  • Federally Qualified Health Center (FQHC)
  • Lawton, OK
National Provider Identifier
1346788296
Registry record updated Jan 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMANCHE COUNTY HOSPITAL AUTHORITY
Doing business as
LCHC Primary Health Care Center at Comanche County Memorial Hospital
Practice address
110 NW 31St St
Suite 201
Lawton, OK 73505-6100
Phone
(580) 355-5242
Fax
(580) 355-5245
NPI assigned
Feb 10, 2017
Last updated
Jan 26, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2018

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

110 NW 31St St
Suite 201
Lawton, OK 73505-6100

Mailing address

PO Box 2309
Lawton, OK 73502-2309
Phone (580) 357-9984

Other names 1

  • LCHC Primary Health Care Center at Comanche County Memorial Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180517000834 OK Part A Provider - Federally Qualified Health Center (FQHC) 2668373689 Practice locations: Lawton, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346788296. Details of each certification follow.

Federally qualified health center certification: CCN 371933

Legal name
COMANCHE COUNTY HOSPITAL AUTHORITY
Doing business as
LCHC PRIMARY HEALTH CARE CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 17, 2018
Last certification
May 17, 2018
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Nov 28, 2006 in OK
Enrollment address
110 NW 31St St
Ste 201
Lawton, OK 73505-6100

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2039019LCHC Primary Health Care Center110 NW 31St Street, Suite 201, Lawton, OK 73505Certificate of waiverMar 28, 2028

National Provider Directory

National Provider Directory
Tax ID family
Commanche Co Mem Hosp41 organizations share this tax ID, including this one

Other organizations with this tax ID 40

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

View all 40

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
George W Kruger Individual Corporate DirectorCfo Aug 3, 2015
W-2 Managing EmployeeCfo Aug 3, 2015
Jervis Jackson Individual Corporate OfficerBoard Member Oct 1, 2022
Amber Murphy Individual Corporate OfficerBoard Secretary Mar 1, 2021
Christine James Individual Corporate OfficerBoard Member Oct 1, 2023
Kathleen Cooper Individual Corporate OfficerBoard Vice Chair Aug 1, 2019
Richard Rogalski Individual Corporate OfficerBoard Member Sep 1, 2015
Brett Simms Individual Corporate OfficerBoard Member Nov 1, 2023
Brent L Smith Individual Corporate DirectorCeo Apr 1, 2014
Rosemary Bellino Hall Individual Corporate OfficerBoard Member May 1, 2020
Debra Johnson Individual Corporate OfficerBoard Member May 1, 2020
Kim Rogalski Individual Corporate OfficerBoard Chair Aug 1, 2019
Brenda Spencer Ragland Individual Corporate OfficerBoard Treasurer Jul 1, 2011
Sean McAvoy Individual Corporate Officer Feb 4, 2013
Corporate DirectorSenior Director Feb 4, 2013
W-2 Managing EmployeeSenior Director Feb 4, 2013
Margaret Settle Individual Corporate OfficerBoard Member Mar 1, 2021

All facility ownership & control disclosures 10

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Memorial HealthLawton, OK, CCN 37T056 Hospital Operational/Managerial Control Jan 13, 1971
Memorial HealthLawton, OK, CCN 370056 Hospital Operational/Managerial Control Jan 13, 1971
McMahon Tomlinson Nursing & Rehabilitation CenterLawton, OK, CCN 375562 Skilled nursing facility Operational/Managerial Control Jan 13, 1971
Comanche County Memorial Hospital Home Health CareLawton, OK, CCN 377070 Home health agency Operational/Managerial Control Jan 13, 1971
Comanche County Memorial Hospice and Supportive CareLawton, OK, CCN 371713 Hospice Operational/Managerial Control Jan 13, 1971
Lawton Community Health CenterLawton, OK, CCN 371846 Federally qualified health center Operational/Managerial Control Mar 6, 2008
Comanche County Hospital AuthorityLawton, OK, CCN 371962 Federally qualified health center Operational/Managerial Control Jan 13, 1971
LCHC Medicine ParkMedicine Park, OK, CCN 371975 Federally qualified health center Operational/Managerial Control Jun 1, 2020
LCHC Family Continuity ClinicLawton, OK, CCN 371017 Federally qualified health center Operational/Managerial Control (100%) Aug 29, 2023
MMG Snyder Family Medical ClinicSnyder, OK, CCN 373443 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1996

NPI Registry JSON

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

{
    "created_epoch": "1486684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516924800000",
    "number": "1346788296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2309",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735022309",
            "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": "110 NW 31ST ST",
            "address_2": "SUITE 201",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056100",
            "telephone_number": "580-355-5242",
            "fax_number": "580-355-5245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMANCHE COUNTY HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-10",
        "last_updated": "2018-01-26",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "580-355-8620"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LCHC Primary Health Care Center at Comanche County Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.