NPIMap

Organization Active NPI

Comanche County Hospital Authority

Doing business as Lawton Community Health Center at Jim Taliaferro

  • Federally Qualified Health Center (FQHC)
  • Lawton, OK
National Provider Identifier
1639540883
Registry record updated Oct 19, 2015
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
Lawton Community Health Center at Jim Taliaferro
Practice address
602 SW 38TH St
Lawton, OK 73505-6912
Phone
(580) 355-5242
Fax
(580) 355-5245
NPI assigned
Oct 14, 2015
Last updated
Oct 19, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

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

Authorized official

Name
Sean McAvoy
Title
Director
Phone
(580) 355-5242

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

602 SW 38TH St
Lawton, OK 73505-6912

Mailing address

PO Box 2309
Lawton, OK 73502-2309
Phone (580) 355-5242

Other names 1

  • Lawton Community Health Center at Jim Taliaferro Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445212800000",
    "number": "1639540883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2309",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735022309",
            "telephone_number": "580-355-5242",
            "fax_number": "580-355-5245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 SW 38TH ST",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056912",
            "telephone_number": "580-355-5242",
            "fax_number": "580-355-5245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMANCHE COUNTY HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-14",
        "last_updated": "2015-10-19",
        "status": "A",
        "authorized_official_last_name": "MCAVOY",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "580-355-5242"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lawton Community Health Center at Jim Taliaferro",
            "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 Oct 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.