NPIMap

Organization Active NPI

Comanche County Hospital Authority

Doing business as LCHC Apache Clinic

  • Federally Qualified Health Center (FQHC)
  • Apache, OK
National Provider Identifier
1609897461
Registry record updated Jan 10, 2024
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 Apache Clinic
Practice address
1102 South Cobb Lake Street
Apache, OK 73006
Phone
(580) 588-3257
Fax
(580) 588-3265
NPI assigned
Jul 21, 2006
Last updated
Jan 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 16693 OK
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1102 South Cobb Lake Street
Apache, OK 73006

Mailing address

3401 W Gore Blvd
Lawton, OK 73505-6332
Phone (580) 585-5443

Other names 1

  • LCHC Apache Clinic 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
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
O20200930000556 OK Part A Provider - Federally Qualified Health Center (FQHC) 2668373689 Practice locations: Apache, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609897461. Details of each certification follow.

Federally qualified health center certification: CCN 371959

Legal name
COMANCHE COUNTY HOSPITAL AUTHORITY
Doing business as
MEMORIAL HEALTH LCHC APACHE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 30, 2020
Last certification
Sep 30, 2020
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Enrollment address
1102 S Coblake St
Apache, OK 73006-8337

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

Member of 1

Organizations this organization is a member of, according to 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
Kameron Good Individual Corporate OfficerBoard of Directors, Member Dec 1, 2025
Melissa Simms Individual Corporate OfficerBoard of Directors, Member Nov 1, 2023
George W Kruger Individual Corporate Director Aug 3, 2015
Katrina Wrensford Individual Corporate OfficerBoard of Directors, Secretary Oct 1, 2024
Christine James Individual Corporate OfficerBoard of Directors, Vice Chair Oct 1, 2023
Richard Rogalski Individual Corporate OfficerBoard of Directors, Chair Sep 1, 2015
Brett Simms Individual Corporate OfficerBoard of Directors, Member Nov 1, 2023
Brent L Smith Individual Corporate DirectorCeo Apr 1, 2014
W-2 Managing Employee Apr 1, 2014
Rosemary Bellino Hall Individual Corporate OfficerMember May 1, 2020
Yolanda Allen Individual Corporate OfficerBoard of Directors, Member Mar 1, 2024
Brenda Spencer Ragland Individual Corporate OfficerBoard of Directors, Treasurer May 1, 2018
Sean McAvoy Individual Corporate DirectorSenior Director Feb 4, 2013
Gloria Martinez Individual Corporate OfficerBoard of Directors, Member Jun 1, 2024

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 1

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": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704844800000",
    "number": "1609897461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 W GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056332",
            "telephone_number": "580-585-5443",
            "fax_number": "580-357-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 SOUTH COBB LAKE STREET",
            "city": "APACHE",
            "state": "OK",
            "postal_code": "73006",
            "telephone_number": "580-588-3257",
            "fax_number": "580-588-3265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMANCHE COUNTY HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "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": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "16693",
            "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": "LCHC Apache Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Apache, OK

Sources for this page

Verify at the official NPI Registry.