Individual provider Active NPI

Lance Mwangi, MD

  • Family Medicine Physician
  • Ardmore, OK
National Provider Identifier
1730765298
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
44293 Issued in OK
Practice address
20 12TH Ave NW
Ardmore, OK 73401-5722
Phone
(580) 223-3411
Fax
(580) 226-2284
NPI assigned
Mar 23, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 44293 OK Primary

Addresses

Primary practice location

20 12TH Ave NW
Ardmore, OK 73401-5722

Mailing address

1104 Walnut Dr
Ardmore, OK 73401-2353
Phone (580) 226-0543

Other practice location 1

1104 Walnut Dr
Ardmore, OK 73401-2353
Phone (580) 226-0543

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241106002106 OK Practitioner - Family Practice 2668871864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas Tech University Health Science Center School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Good Shepherd Community Clinic, Inc.Group PAC ID 4284936337, 19 clinicians

Practice addresses (Care Compare)

1104 Walnut Dr
Ardmore, OK 73401-2353
Phone (580) 223-3411

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
44293OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Good Shepherd Community Clinic, Inc. CurrentSince Oct 24, 2024 Accepting new patients
Mercy Hospital Ardmore, Inc. Past Accepting new patients

Locations

1104 Walnut Dr
Ardmore, OK 73401
Phone 5802233411308

1116 Walnut Dr
Ardmore, OK 73401
Phone (580) 226-0543

2401 N Commerce St
Ste A
Ardmore, OK 73401
Phone (580) 798-4122

20 12th Ave NW
Ardmore, OK 73401
Phone (580) 223-3411

Interoperability endpoints

  • Direct secure messaging: lance.mwangi.1@21725.direct.athenahealth.com

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1730765298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 WALNUT DR",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734012353",
            "telephone_number": "580-226-0543",
            "fax_number": "580-226-2284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 12TH AVE NW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734015722",
            "telephone_number": "580-223-3411",
            "fax_number": "580-226-2284"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1104 Walnut Dr",
            "address_purpose": "LOCATION",
            "city": "Ardmore",
            "state": "OK",
            "postal_code": "734012353",
            "country_code": "US",
            "telephone_number": "580-226-0543",
            "fax_number": "580-226-2284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MWANGI",
        "first_name": "LANCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-23",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "44293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, OK

Sources for this page

Verify at the official NPI Registry.