Active NPI
Elissa J Hunter, MD
- Surgery Physician
- Lawton, OK
National Provider Identifier
1528054822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 22510
- Practice address
- 110 NW 31St St
3Rd Floor
Lawton, OK 73505-6100 - Phone
- (580) 510-7042
- Fax
- (580) 510-7044
- NPI assigned
- Sep 22, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 22510 | OK | Primary |
Addresses
Primary practice location
110 NW 31St St
3Rd Floor
Lawton, OK 73505-6100
Mailing address
PO Box 785
Lawton, OK 73502
Phone (580) 357-9984
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020053163 | Other | RAILROAD MEDICARE | |
| 7648345 | Other | OK | AETNA |
| 347459110 | Other | KS | DOL |
| 100097930A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22510 | OK | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackson County Memorial Hospital Authority | Past | Accepting new patients | |
| Comanche County Healthcare Corp | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Vascular Surgery Physician
- Lawton, OK
- NPI 1558472506
-
- General Acute Care Hospital
- Altus, OK
- NPI 1093763781
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231804800000",
"number": "1528054822",
"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": "110 NW 31ST ST",
"address_2": "3RD FLOOR",
"city": "LAWTON",
"state": "OK",
"postal_code": "735056100",
"telephone_number": "580-510-7042",
"fax_number": "580-510-7044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUNTER",
"first_name": "ELISSA",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-22",
"last_updated": "2009-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "OK",
"license": "22510",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "020053163",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7648345",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DOL",
"identifier": "347459110",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100097930A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}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 Jan 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.