NPIMap

Organization Active NPI

Comanche County Hospital Authority

  • Federally Qualified Health Center (FQHC)
  • Lawton, OK
National Provider Identifier
1992183099
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMANCHE COUNTY HOSPITAL AUTHORITY
Doing business as
LCHC Center for Health
MMG Center for Health
Practice address
3811 W Gore Blvd
Suite 6
Lawton, OK 73505-6310
Phone
(580) 250-6525
NPI assigned
May 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Authorized official

Name
Brent Smith
Title
Cfo
Phone
(580) 510-7070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

3811 W Gore Blvd
Suite 6
Lawton, OK 73505-6310

Mailing address

PO Box 2309
Section 2
Lawton, OK 73502-0785
Phone (580) 357-9984

Other names 2

  • LCHC Center for Health Doing business as
  • MMG Center for Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031106000742 OK Part B Supplier - Clinic/Group Practice 0749192433 Receives reassigned benefits from 166 practitioners
40 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lawton, OK; Oklahoma City, OK; Pawhuska, OK; Snyder, OK; Tahlequah, OK; The Village, OK; Edmond, OK; Frederick, OK
O20171003004099 OK Part A Provider - Federally Qualified Health Center (FQHC) 2668373689 Practice locations: Lawton, OK

Federally qualified health center certification: CCN 371929

Legal name
COMANCHE COUNTY HOSPITAL AUTHORITY
Doing business as
LCHC CENTER FOR HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 2, 2017
Last certification
Oct 2, 2017
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Nov 28, 2006 in OK
Enrollment address
3811 W Gore Blvd
Ste 6
Lawton, OK 73505-6328

Other NPIs on the same Medicare enrollment 39

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 39

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2109641LCHC Center for Health3811 West Gore Blvd, Suite 6, Lawton, OK 73505Certificate of waiverFeb 28, 2028

National Provider Directory

National Provider Directory
Tax ID family
Comanche County Hospita40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

Organizations that report the same tax identification number in the National Provider Directory.

View all 39

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Maria Louis Individual Corporate OfficerMember Sep 1, 2016
George W Kruger Individual Corporate DirectorCfo Aug 3, 2015
W-2 Managing EmployeeCfo Aug 3, 2015
Pamela Nation Individual Corporate OfficerVice- Chairman Oct 1, 2013
Richard Rogalski Individual Corporate OfficerTreasurer Sep 1, 2015
Brent L Smith Individual Corporate DirectorCeo Apr 1, 2014
W-2 Managing EmployeeCeo Apr 1, 2014
Brandie O'Connor Individual Corporate OfficerMember Feb 1, 2013
Christy Jackson Individual Corporate OfficerMember Aug 1, 2016
Sean McAvoy Individual Corporate DirectorDirector Feb 4, 2013
W-2 Managing EmployeeDirector Feb 4, 2013
Virginia Breeden Individual Corporate OfficerChairman Jul 1, 2017
Anthony Griffith Individual Corporate OfficerMember Sep 1, 2015
Chris Meyers Individual Corporate Officer Jun 1, 2012
Jessie Cross Individual Corporate OfficerMember Jul 1, 2017
Buster Swoopes Individual Corporate Officer Jul 1, 2016

All facility ownership & control disclosures 10

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Memorial HealthLawton, OK, CCN 37T056 Hospital Operational/Managerial Control Jan 13, 1971
Memorial HealthLawton, OK, CCN 370056 Hospital Operational/Managerial Control Jan 13, 1971
McMahon Tomlinson Nursing & Rehabilitation CenterLawton, OK, CCN 375562 Skilled nursing facility Operational/Managerial Control Jan 13, 1971
Comanche County Memorial Hospital Home Health CareLawton, OK, CCN 377070 Home health agency Operational/Managerial Control Jan 13, 1971
Comanche County Memorial Hospice and Supportive CareLawton, OK, CCN 371713 Hospice Operational/Managerial Control Jan 13, 1971
Lawton Community Health CenterLawton, OK, CCN 371846 Federally qualified health center Operational/Managerial Control Mar 6, 2008
Comanche County Hospital AuthorityLawton, OK, CCN 371962 Federally qualified health center Operational/Managerial Control Jan 13, 1971
LCHC Medicine ParkMedicine Park, OK, CCN 371975 Federally qualified health center Operational/Managerial Control Jun 1, 2020
LCHC Family Continuity ClinicLawton, OK, CCN 371017 Federally qualified health center Operational/Managerial Control (100%) Aug 29, 2023
MMG Snyder Family Medical ClinicSnyder, OK, CCN 373443 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1996

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704844800000",
    "number": "1992183099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2309",
            "address_2": "SECTION 2",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735020785",
            "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": "3811 W GORE BLVD",
            "address_2": "SUITE 6",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056310",
            "telephone_number": "580-250-6525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMANCHE COUNTY HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-11",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "580-510-7070"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LCHC Center for Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LCHC Center for Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MMG Center for Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.