Active NPI
Nancy Collazo, M.D.
- Neonatal-Perinatal Medicine Physician
- Lawton, OK
National Provider Identifier
1629273339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 11352
- Practice address
- 9 NW Shelter Lake Drive
Lawton, OK 73505-3739 - Phone
- (337) 356-7592
- NPI assigned
- Jun 20, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 11352 | PR | Primary |
Addresses
Primary practice location
9 NW Shelter Lake Drive
Lawton, OK 73505-3739
Mailing address
9 NW Shelter Lake Dr
Lawton, OK 73505-3739
Phone (337) 356-7592
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11352 | PR | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lawton Indian Hospital | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Lawton, OK
- NPI 1760489223
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321574400000",
"number": "1629273339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 NW SHELTER LAKE DR",
"city": "LAWTON",
"state": "OK",
"postal_code": "735053739",
"telephone_number": "337-356-7592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 NW SHELTER LAKE DRIVE",
"city": "LAWTON",
"state": "OK",
"postal_code": "735053739",
"telephone_number": "337-356-7592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLAZO",
"first_name": "NANCY",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-20",
"last_updated": "2011-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "PR",
"license": "11352",
"primary": true
}
],
"identifiers": [],
"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 Nov 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.