Individual provider Active NPI

Daniel Glenn Constance, M.D.

  • Internal Medicine Physician
  • Lawton, OK
National Provider Identifier
1912110578
Registry record updated Aug 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
26711 Issued in OK
Practice address
5606 SW Lee Boulevard
Suite 203
Lawton, OK 73505
Phone
(580) 536-1111
NPI assigned
May 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2011

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301082389 MI
Internal Medicine Physician 207R00000X 26711 OK Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 4301082389 MI
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 26711 OK
Sports Medicine (Internal Medicine) Physician 207RS0010X 4301082389 MI
Sports Medicine (Internal Medicine) Physician 207RS0010X 26711 OK

Addresses

Primary practice location

5606 SW Lee Boulevard
Suite 203
Lawton, OK 73505

Mailing address

5606 SW Lee Blvd
Suite 203
Lawton, OK 73505-0000
Phone (580) 536-1111

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
I20090202000106 OK Practitioner - Internal MedicinePractitioner - Geriatric MedicinePractitioner - Other (Physician) 1850455148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3401 W Gore Blvd
Lawton, OK 73505-6332
Phone (580) 510-7037

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301082389MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comanche County Healthcare Corporation Current Accepting new patients
Comanche County Healthcare Corporation CurrentSince Mar 4, 2017 Accepting new patients
Comanche County Healthcare Corporation CurrentSince Mar 4, 2017 Accepting new patients
Comanche County Healthcare Past Accepting new patients
Comanche County 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

5606 SW Lee Blvd
Ste 203
Lawton, OK 73505
Phone (580) 531-6469

Interoperability endpoints

  • Direct secure messaging: daniel.constance@mmg.eclinicaldirectplus.com
  • FHIR API: https://api.platform.athenahealth.com/5038/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314316800000",
    "number": "1912110578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5606 SW LEE BLVD",
            "address_2": "SUITE 203",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735050000",
            "telephone_number": "580-536-1111",
            "fax_number": "580-536-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5606 SW LEE BOULEVARD",
            "address_2": "SUITE 203",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "73505",
            "telephone_number": "580-536-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSTANCE",
        "first_name": "DANIEL",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2011-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301082389",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "26711",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MI",
            "license": "4301082389",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "OK",
            "license": "26711",
            "primary": false
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "MI",
            "license": "4301082389",
            "primary": false
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "OK",
            "license": "26711",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.