NPIMap

Organization Active NPI

Southwestern Neurosurgery Physicians LLC

Doing business as Southwestern Neurosciences

  • Neurological Surgery Physician
  • Lawton, OK
National Provider Identifier
1477595924
Registry record updated Aug 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
23774 Issued in OK
Legal business name
SOUTHWESTERN NEUROSURGERY PHYSICIANS LLC
Doing business as
Southwestern Neurosciences
Practice address
5604 SW Lee Blvd
Suite 357
Lawton, OK 73505-9681
Phone
(580) 531-4600
Fax
(580) 531-6405
NPI assigned
Jun 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2008

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

Authorized official

Name
Mr. Jon O'Shaughnessy
Title
Ceo
Phone
(580) 531-4600

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X 23774 OK Primary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X 26013 OK
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X 25895 OK
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X 25956 OK

Addresses

Primary practice location

5604 SW Lee Blvd
Suite 357
Lawton, OK 73505-9681

Mailing address

5604 SW Lee Blvd
Suite 357
Lawton, OK 73505-9681
Phone (580) 531-4600

Other identifiers 3

IdentifierTypeStateIssuer
200051010AMedicaidOK
200199360AMedicaidOK
200035200AMedicaidOK

Other names 1

  • Southwestern Neurosciences Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

5604 SW Lee Blvd
Ste 357
Lawton, OK 73505
Phone (580) 531-4600

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219449600000",
    "number": "1477595924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5604 SW LEE BLVD",
            "address_2": "SUITE 357",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735059681",
            "telephone_number": "580-531-4600",
            "fax_number": "580-531-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5604 SW LEE BLVD",
            "address_2": "SUITE 357",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735059681",
            "telephone_number": "580-531-4600",
            "fax_number": "580-531-6405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWESTERN NEUROSURGERY PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2008-08-23",
        "status": "A",
        "authorized_official_last_name": "O'SHAUGHNESSY",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "580-531-4600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": "OK",
            "license": "23774",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OK",
            "license": "26013",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "OK",
            "license": "25895",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "OK",
            "license": "25956",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200051010A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200199360A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200035200A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southwestern Neurosciences",
            "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 Aug 23, 2008; 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.