Comanche County Hospital Authority
Organization Active NPI Federally Qualified Health Center (FQHC) · Comanche, OK
NPI 1427075498 · NPPES record last updated Nov 19, 2015
Key facts
- NPI
- 1427075498
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- COMANCHE COUNTY HOSPITAL AUTHORITY
- Practice address
- 513 Hilary
Suite C
Comanche, OK 73529 - Phone
- (580) 439-2000
- Fax
- (580) 439-5669
- NPI assigned
- Jul 16, 2006
- Organization subpart
- No
Authorized official
- Name
- Brent Smith
- Title
- Cfo
- Phone
- (580) 355-8620
Other NPIs on the same Medicare enrollment 50
Corporate family (same tax ID) 39
Practitioners 2
-
Sameh W Hanna, M.D.
-
Tariq Bin Masud Niazi, MD, FRCSI, MSC, FICS
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (4 enrollments) in OK
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
- Other · Non-profit
- Incorporated
- Jul 31, 2015 in OK
- Enrollment address
- 513 Hillery Rd
Comanche, OK 73529-1200
All disclosed owners & managing parties 13
| Name | Role | Since | Share |
|---|---|---|---|
| George W Kruger |
Corporate Director |
Aug 3, 2015 | |
| W-2 Managing Employee |
Aug 3, 2015 | ||
| Ladonna Meyer |
Corporate Officer | May 1, 2020 | |
| Kathleen Cooper |
Corporate Officer | Aug 1, 2019 | |
| Brent L Smith |
5% Or Greater Direct Ownership Interest | Apr 1, 2014 | |
| Corporate Director | Apr 1, 2014 | ||
| W-2 Managing Employee | Apr 1, 2014 | ||
| Rosemary Bellino Hall |
Corporate Officer | May 1, 2020 | |
| Debra Johnson |
Corporate Officer | May 1, 2020 | |
| Kim Rogalski |
Corporate Officer | Aug 1, 2019 | |
| Brenda Spencer Ragland |
Corporate Officer | Jul 1, 2011 | |
| Sean McAvoy |
Corporate Director |
Feb 4, 2013 | |
| W-2 Managing Employee |
Feb 4, 2013 | ||
| Virginia Breeden |
Corporate Officer | Jul 1, 2016 | |
| Cynthia Tracy |
Corporate Officer | May 1, 2018 | |
| Buster Swoopes |
Corporate Officer | Jul 1, 2016 | |
| Margaret Settle |
Corporate Officer | Mar 15, 2021 |
All facility ownership & control disclosures 10
| Facility | Type | Role | Since |
|---|---|---|---|
| Memorial Health |
Hospital | Operational/Managerial Control | Jan 13, 1971 |
| Memorial Health |
Hospital | Operational/Managerial Control | Jan 13, 1971 |
| McMahon Tomlinson Nursing & Rehabilitation Center |
Skilled nursing facility | Operational/Managerial Control | Jan 13, 1971 |
| Comanche County Memorial Hospital Home Health Care |
Home health agency | Operational/Managerial Control | Jan 13, 1971 |
| Comanche County Memorial Hospice and Supportive Care |
Hospice | Operational/Managerial Control | Jan 13, 1971 |
| Lawton Community Health Center |
Federally qualified health center | Operational/Managerial Control | Mar 6, 2008 |
| Comanche County Hospital Authority |
Federally qualified health center | Operational/Managerial Control | Jan 13, 1971 |
| LCHC Medicine Park |
Federally qualified health center | Operational/Managerial Control | Jun 1, 2020 |
| LCHC Family Continuity Clinic |
Federally qualified health center | Operational/Managerial Control (100%) | Aug 29, 2023 |
| MMG Snyder Family Medical Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 1996 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Comanche County Hospita
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 13927 | OK | |
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
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
- Comanche Community Health Center
Other providers in Comanche, OK
- William W Baker
- Sharla Kay Carr
- Timothy Carroll
- Abby Gail Christian
- Comanche County Hospital Authority
- Comanche Public Schools
- Comanche RX Inc
- Carole Conner
- Christine Crawford
All providers in Comanche, OK · Federally Qualified Health Center (FQHC) in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.