Prompt Care Clinic LLC

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

Legal business name

PROMPT CARE CLINIC LLC

Practice address

4008 NW Cache Rd
Lawton, OK 73505-3634

Phone

(580) 379-0200

Fax

(580) 699-8767

NPI assigned

Apr 7, 2020

Organization subpart

No

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

Authorized official

Name

Jeffery Charles Hickman, PHYSICIAN ASSISTANT

Title

Manger

Phone

(580) 512-2780

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586217600000",
    "number": "1962031369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4008 NW CACHE RD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735053634",
            "telephone_number": "580-379-0200",
            "fax_number": "580-699-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4008 NW CACHE RD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735053634",
            "telephone_number": "580-379-0200",
            "fax_number": "580-699-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMPT CARE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-07",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A",
        "authorized_official_last_name": "HICKMAN",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "MANGER",
        "authorized_official_telephone_number": "580-512-2780",
        "authorized_official_credential": "PHYSICIAN ASSISTANT"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356390397",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598999757",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Lawton",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "4008 NW Cache Rd",
            "city": "Lawton",
            "state": "OK",
            "country_code": "US",
            "postal_code": "735053634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Addiction Medicine (Family Medicine) Physician in Lawton, OK
• Providers in Lawton, OK by specialty
• Addiction Medicine (Family Medicine) Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.