Individual provider Active NPI

Johnny D Duncan, DO

  • Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
  • Lawton, OK
National Provider Identifier
1790771095
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromuscular Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081N0008X
License
3110 Issued in OK
Practice address
3201 W Gore Blvd Ste 201
Lawton, OK 73505-6350
Phone
(805) 250-6659
Fax
(580) 250-5249
NPI assigned
Sep 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 3110 OK
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician 2081N0008X 3110 OK Primary

Addresses

Primary practice location

3201 W Gore Blvd Ste 201
Lawton, OK 73505-6350

Mailing address

PO Box 785
Lawton, OK 73502
Phone (580) 357-9984

Other practice location 1

3201 W Gore Blvd Ste 104
Lawton, OK 73505-6350
Phone (805) 250-6659

Other identifiers 4

IdentifierTypeStateIssuer
175194701OtherOKDOL
5959599OtherOKAETNA
100765610BMedicaidOK
140007299OtherRAILROAD MEDICARE

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
I20100203000508 OK Practitioner - Physical Medicine and RehabilitationPractitioner - Neurosurgery 7810030525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Oklahoma State University College of Osteopathic Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comanche County Healthcare CorporationGroup PAC ID 0749192433, 125 clinicians

Practice addresses (Care Compare)

3201 W Gore Blvd
Suite 201
Lawton, OK 73505-6350
Phone (580) 357-2261

Hospital & facility affiliations

  • Memorial Health Hospital, Lawton, OK, CCN 370056

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3110OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Comanche County Healthcare Corporation Current Accepting new patients
Comanche County Healthcare Corp CurrentSince Sep 1, 2000 Accepting new patients
Comanche County Healthcare Corporation CurrentSince Sep 1, 2000 Accepting new patients
Summit Medical Center Past Accepting new patients
Comanche County Healthcare Corporation Neurological Surgery Past Accepting new patients
Comanche County Healthcare Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

3201 W Gore Blvd
Ste 300
Lawton, OK 73505
Phone (580) 248-5255

3401 W Gore Blvd
Lawton, OK 73505
Phone (580) 483-5207

3201 W Gore Blvd
Ste 201
Lawton, OK 73505
Phone (580) 357-2261

3201 W Gore Blvd
Ste 104
Lawton, OK 73505
Phone (580) 250-6659

Interoperability endpoints

  • Direct secure messaging: johnny.duncan@mmg.eclinicaldirectplus.com

Organizations & group practices 7

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 3

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": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1790771095",
    "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": "3201 W GORE BLVD STE 201",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056350",
            "telephone_number": "805-250-6659",
            "fax_number": "580-250-5249"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3201 W Gore Blvd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Lawton",
            "state": "OK",
            "postal_code": "735056350",
            "country_code": "US",
            "telephone_number": "805-250-6659",
            "fax_number": "580-250-5249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUNCAN",
        "first_name": "JOHNNY",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OK",
            "license": "3110",
            "primary": false
        },
        {
            "code": "2081N0008X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Neuromuscular Medicine",
            "state": "OK",
            "license": "3110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL",
            "identifier": "175194701",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5959599",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100765610B",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "140007299",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.