NPIMap

Individual provider Active NPI

Corinna A Irwin, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Lawton, OK
National Provider Identifier
1902049141
Registry record updated Dec 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
30757 Issued in OK
Practice address
4208 SW Lee Blvd Dept of
Lawton, OK 73505-8331
Phone
(580) 536-7400
Fax
(580) 536-7402
NPI assigned
Apr 17, 2009
Last updated
Dec 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 30757 OK Primary

Addresses

Primary practice location

4208 SW Lee Blvd Dept of
Lawton, OK 73505-8331

Mailing address

4208 SW Lee Blvd Dept of
Lawton, OK 73505-8331
Phone (580) 536-7400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141205000264 OK Practitioner - Pathology 5890017669 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Louisiana State University School of Medicine in Shreveport, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comanche County Hospital AuthorityGroup PAC ID 3779728936, 4 clinicians

Practice addresses (Care Compare)

3401 W Gore Blvd
MMG Pathology Services
Lawton, OK 73505-6332
Phone (580) 355-8620

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mawd Pathology Group Inc Anatomic Pathology & Clinical Pathology CurrentSince Feb 3, 2019 Accepting new patients
Mercy Clinic Oklahoma Communities CurrentSince Aug 4, 2014 Accepting new patients
Comanche County Hospital Authority Anatomic Pathology & Clinical Pathology CurrentSince Aug 1, 2024 Accepting new patients

Locations

9705 Lenexa Dr
Lenexa, KS 66215
Phone (913) 361-8528

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

4208 SW Lee Blvd
Lawton, OK 73505
Phone (580) 353-0314

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1239926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545868800000",
    "number": "1902049141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4208 SW LEE BLVD DEPT OF",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735058331",
            "telephone_number": "580-536-7400",
            "fax_number": "580-536-7402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4208 SW LEE BLVD DEPT OF",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735058331",
            "telephone_number": "580-536-7400",
            "fax_number": "580-536-7402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRWIN",
        "first_name": "CORINNA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-17",
        "last_updated": "2018-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OK",
            "license": "30757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.