NPIMap

Organization Active NPI

Comanche County Hospital Authority

Doing business as Comanche Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Comanche, OK
National Provider Identifier
1427075498
Registry record updated Nov 19, 2015
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
Comanche Community Health Center
Practice address
513 Hilary
Suite C
Comanche, OK 73529
Phone
(580) 439-2000
Fax
(580) 439-5669
NPI assigned
Jul 16, 2006
Last updated
Nov 19, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 13927 OK
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

513 Hilary
Suite C
Comanche, OK 73529

Mailing address

PO Box 2309
Lawton, OK 73502-2309
Phone (580) 439-2000

Other names 1

  • Comanche Community Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK4 enrollments

Enrollment records 4

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
O20140602001702 OK Part B Supplier - Clinic/Group Practice 2668373689 Receives reassigned benefits from 79 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lawton, OK
O20151215001261 OK Part A Provider - Federally Qualified Health Center (FQHC) 2668373689 1 other NPI on this enrollment
Practice locations: Comanche, OK
O20160428000839 OK Part B Supplier - Clinic/Group Practice 2668373689 Receives reassigned benefits from 10 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lawton, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1427075498. Details of each certification follow.

Federally qualified health center certification: CCN 371909

Legal name
COMANCHE COUNTY HOSPITAL AUTHORITY
Doing business as
COMANCHE COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 15, 2015
Last certification
Dec 15, 2015
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Jul 31, 2015 in OK
Enrollment address
513 Hillery Rd
Comanche, OK 73529-1200

Other NPIs on the same Medicare enrollment 50

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 50

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

Member organizations 8

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 13

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
Ladonna Meyer Individual Corporate Officer May 1, 2020
Kathleen Cooper Individual Corporate Officer Aug 1, 2019
Brent L Smith Individual 5% Or Greater Direct Ownership Interest Apr 1, 2014
Corporate Director Apr 1, 2014
W-2 Managing Employee Apr 1, 2014
Rosemary Bellino Hall Individual Corporate Officer May 1, 2020
Debra Johnson Individual Corporate Officer May 1, 2020
Kim Rogalski Individual Corporate Officer Aug 1, 2019
Brenda Spencer Ragland Individual Corporate Officer Jul 1, 2011
Sean McAvoy Individual Corporate DirectorSenior Director Feb 4, 2013
W-2 Managing EmployeeSenior Director Feb 4, 2013
Virginia Breeden Individual Corporate Officer Jul 1, 2016
Cynthia Tracy Individual Corporate Officer May 1, 2018
Buster Swoopes Individual Corporate Officer Jul 1, 2016
Margaret Settle Individual Corporate Officer Mar 15, 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

Practitioners & affiliated clinicians

Practitioners 2

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.

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": "1447891200000",
    "number": "1427075498",
    "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": "580-439-2000",
            "fax_number": "580-439-5669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 HILARY",
            "address_2": "SUITE C",
            "city": "COMANCHE",
            "state": "OK",
            "postal_code": "73529",
            "telephone_number": "580-439-2000",
            "fax_number": "580-439-5669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMANCHE COUNTY HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2015-11-19",
        "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": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "13927",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comanche Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Comanche, OK

Sources for this page

Verify at the official NPI Registry.