SOUTHWESTERN MEDICAL CENTER (NPI# 1245316447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245316447 |
| Entity Type | Organization |
| Organization Name | SOUTHWESTERN MEDICAL CENTER |
| Practice Address |
5602 Sw Lee Blvd Lawton OK 73505-9635 |
| Practice Telephone | 5805314700 |
| Mailing Telephone | 5805314700 |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2010-09-30 |
| Authorized Official Name | MR. SHELTON RAY COFFEY (VP REIMBURSEMENT) |
| Authorized Official Telephone | 6157643009 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHWESTERN MEDICAL CENTER, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | 2231 | OK | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100697950F | 05 |
| Street Address |
5602 SW LEE BLVD |
| City | LAWTON |
| State | OK |
| Zip Code | 73505-9635 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326044603 | Dennis Dodd | Nurse Anesthetist, Certified Registered | 5602 Sw Lee Blvd, Lawton, OK 73505-9635 | 2005-06-22 |
| 1629531900 | Malaya Reyna Deemer | Nurse Practitioner | 5602 Sw Lee Blvd, Lawton, OK 73505-9699 | 2019-04-12 |
| 1295213106 | Kylie Danielle Starnes | Nurse Practitioner | 5602 Sw Lee Blvd, Lawton, OK 73505-9699 | 2018-08-02 |
| 1669963575 | Catherine H Phipps | Physician Assistant | 5602 Sw Lee Blvd, Lawton, OK 73505-9699 | 2018-05-25 |
| 1558730952 | Deanna Harmon | Registered Nurse | 5602 Sw Lee Blvd, Lawton, OK 73505-9699 | 2015-09-16 |
| 1881909604 | Southwestern Radiology Affiliates, LLC | Radiology | 5602 Sw Lee Blvd, Lawton, OK 73505-9635 | 2010-08-17 |
| 1538472899 | Chad Reid | Family Medicine | 5602 Sw Lee Blvd, Lawton, OK 73505-9635 | 2010-07-15 |
| 1770728412 | Lawton Ems Services, Inc. | Emergency Medicine | 5602 Sw Lee Blvd, Lawton, OK 73505-9635 | 2008-12-10 |
| 1013169531 | Southwestern Surgical Affiliates, LLC | Orthopaedic Surgery | 5602 Sw Lee Blvd, Lawton, OK 73505-9635 | 2008-10-15 |
| 1912186651 | Abdallah M Hussein | Family Medicine | 5602 Sw Lee Blvd, Lawton, OK 73505-9635 | 2007-10-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134744006 | Angela Janell Smith | Case Manager/Care Coordinator | 4904 Nw Smith Ave, Lawton, OK 73505 | 2020-06-16 |
| 1295383990 | Akeemia Lorene Holder | Case Manager/Care Coordinator | Youth Care of Oklahoma, 713 Sw C Avenue, OK 73505 | 2019-08-27 |
| 1225685480 | Healthstat Onsite Clinic Goodyear Vision Center | Preventive Medicine | 1 Goodyear Blvd, Lawton, OK 73505 | 2019-08-22 |
| 1891285300 | Michael Anthony Gray | Case Manager/Care Coordinator | 2218 Nw 36th St, Lawton, OK 73505 | 2018-05-10 |
| 1841797362 | Adeshola T Fatuyi | Case Manager/Care Coordinator | 7301 Sw Lee 635, Lawton, OK 73505 | 2018-04-11 |
| 1912425539 | Heather Shea Morefield | Case Manager/Care Coordinator | 2712 Sw H Ave, Lawton, OK 73505 | 2017-09-04 |
| 1972031367 | Burke Hendricks | Emergency Medicine | 3401 West Gore Boulevard, Lawton, OH 73505 | 2017-05-30 |
| 1932642279 | Helery Vance | Peer Specialist | 1420 Nw Hunter Rd Apt C7, Lawton, OK 73505 | 2016-11-18 |
| 1629523436 | Sebrina Sheppard | Case Manager/Care Coordinator | 3907 Sw Parkridge Blvd., Lawton, OK 73505 | 2016-08-22 |
| 1376913590 | David Lee Atauvich | Registered Nurse | 1515 Lawrie Rd, Lawton, OK 73505 | 2015-09-30 |
| Find all providers in zip 73505 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811370471 | William S, Davies, M.d., Inc. | Psychiatric Residential Treatment Facility | 1302 N, W, Lake Ave, Lawton, OK 73507 | 2015-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053853655 | Brittany Jones | Psychiatric Residential Treatment Facility | 1707 Oak Ln, Miami, OK 74354-1429 | 2016-11-14 |
| 1376905976 | Kls Care Centers | Psychiatric Residential Treatment Facility | 17364 State Highway 9, Norman, OK 73072-8732 | 2016-03-23 |
| 1750719886 | Marylee Gaskins | Psychiatric Residential Treatment Facility | 302 E 19th St, Owasso, OK 74055-4612 | 2013-10-29 |
| 1174898852 | Domonique Montrell Lugrand | Psychiatric Residential Treatment Facility | 2220 S Santa Fe Apt 105, Moore, OK 73160-5238 | 2012-03-14 |
| 1447521885 | Childrens Eecovery Center | Psychiatric Residential Treatment Facility | 2220 S Santa Fe Ave Apt 105, Moore, OK 73160-2866 | 2012-01-17 |
| 1144527227 | Riverside Behavioral Health | Psychiatric Residential Treatment Facility | 4618 S 31st West Ave, Tulsa, OK 74107-7532 | 2011-02-25 |
| 1760782882 | Lori Suzanne Frock | Psychiatric Residential Treatment Facility | 66 Overland Rt, Ardmore, OK 73401 | 2010-10-22 |
| 1215261086 | Brenda Sue Mathis | Psychiatric Residential Treatment Facility | 4034 W Roanoke Pl, Broken Arrow, OK 74011-1327 | 2009-09-28 |
| 1346424363 | Southern Plains Treatment Services | Psychiatric Residential Treatment Facility | 310 12th Ave Ne, Norman, OK 73071-5238 | 2007-12-27 |
| 1346461688 | Parkside, Inc. | Psychiatric Residential Treatment Facility | 1619 E 13th St, Tulsa, OK 74120-5410 | 2007-05-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.