COMANCHE COUNTY HEALTHCARE CORP (NPI# 1285886713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285886713 |
| Entity Type | Organization |
| Organization Name | COMANCHE COUNTY HEALTHCARE CORP |
| Other Organization Name | MNT DIABETES SERVICES |
| Practice Address |
3201 W Gore Blvd Suite 103 Lawton OK 73505-6378 |
| Mailing Address |
Po Box 785 Lawton OK 73502-0785 |
| Practice Telephone | 5802506407 |
| Practice Fax Number | 5803555893 |
| Mailing Telephone | 5803579984 |
| Mailing Fax Number | 5803573277 |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2015-05-08 |
| Authorized Official Name | BRENT SMITH (CFO) |
| Authorized Official Telephone | 5803558620 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133VN1006X |
Dietitian, Registered Specialization: Nutrition, Metabolic |
Dietary & Nutritional Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100810030L | 05 |
| Other Name | Type Code |
|---|---|
| MNT DIABETES SERVICES | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437775848 | Comanche County Healthcare Corp | Internal Medicine | 3201 W Gore Blvd Ste 103, Lawton, OK 73505-6350 | 2020-06-22 |
| 1891039517 | Comanche County Healthcare Corp | Internal Medicine | 3201 W Gore Blvd, Suite 202, Lawton, OK 73505-6378 | 2012-11-19 |
| 1659647501 | Comanche County Healthcare Corp | Family Medicine | 3201 W Gore Blvd, Ste 300, Lawton, OK 73505-6378 | 2012-03-26 |
| 1164736351 | Comanche County Healthcare Corp | Internal Medicine | 3201 W Gore Blvd, Suite 203, Lawton, OK 73505-6378 | 2010-07-30 |
| 1558472506 | Comanche County Healthcare Corp | Surgery | 110 Nw 31st St, 3rd Floor, Lawton, OK 73505-6100 | 2006-08-31 |
| 1346269925 | Comanche County Healthcare Corp | Family Medicine | 102 N Broadway, Carnegie, OK 73015 | 2006-07-18 |
| Street Address |
3201 W GORE BLVD SUITE 103 |
| City | LAWTON |
| State | OK |
| Zip Code | 73505-6378 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144227273 | Prabhudas Khodidas Patel | Surgery | 3201 W Gore Blvd, Suite 103, Lawton, OK 73505-6378 | 2005-07-05 |
| 1245744986 | Stephanie Morris | Nurse Practitioner | 3201 W Gore Blvd, Lawton, OK 73505-6378 | 2017-11-16 |
| 1114466455 | Comanche County Healthcare Corporation | Family Medicine | 3201 W Gore Blvd, Suite 203, Lawton, OK 73505-6378 | 2017-02-20 |
| 1609315308 | Comanche County Healthcare Corporation | Otolaryngology | 3201 W Gore Blvd, Suite 103, Lawton, OK 73505-6378 | 2017-02-15 |
| 1174901102 | Comanche County Healthcare Corportation | Pediatrics | 3201 W Gore Blvd, Suite G1, Lawton, OK 73505-6378 | 2015-05-11 |
| 1780027433 | Amber Lee Cobia | Physical Therapist | 3201 W Gore Blvd, Lawton, OK 73505-6378 | 2013-04-12 |
| 1891039517 | Comanche County Healthcare Corp | Internal Medicine | 3201 W Gore Blvd, Suite 202, Lawton, OK 73505-6378 | 2012-11-19 |
| 1629328786 | Sherif Sayed Ismail Md PC | Skilled Nursing Facility | 3201 W Gore Blvd, Suite 105, Lawton, OK 73505-6378 | 2012-09-17 |
| 1659647501 | Comanche County Healthcare Corp | Family Medicine | 3201 W Gore Blvd, Ste 300, Lawton, OK 73505-6378 | 2012-03-26 |
| 1164736351 | Comanche County Healthcare Corp | Internal Medicine | 3201 W Gore Blvd, Suite 203, Lawton, OK 73505-6378 | 2010-07-30 |
| Find all providers in the same location | ||||
| 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 | 133VN1006X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| Specialization | Nutrition, Metabolic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851513600 | Rebecca Sue Hollander | Dietitian, Registered | 3401 W Gore Blvd, Lawton, OK 73505-6332 | 2007-05-02 |
| 1245452002 | Jan Marie Miller | Dietitian, Registered | 3401 W Gore Blvd, Lawton, OK 73505-6332 | 2007-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558867788 | Ashley Lynn Ethriedge | Dietitian, Registered | 1200 N Phillips Ave Ste 12100, Oklahoma City, OK 73104-4600 | 2018-04-05 |
| 1104191931 | Suzanne Elizabeth Gauldin | Dietitian, Registered | 12175 N 179th East Ave, Collinsville, OK 74021-6259 | 2012-03-12 |
| 1174805147 | Jessica Rae Shaw | Dietitian, Registered | 1000 N Lincoln Ave, Sutie 2900, Oklahoma City, OK 73104 | 2011-09-15 |
| 1659593168 | Banister & Associates LLC | Dietitian, Registered | 4200 West Memorial Rd, Suite 508, Oklahoma City, OK 73120 | 2007-05-03 |
| 1982747861 | Betty Jean Chuculate | Dietitian, Registered | 1265 South Utica Ste. 100n, Tulsa, OK 74104-4090 | 2007-02-14 |
| 1134220171 | William Keith Glodowski | Dietitian, Registered | 921 Ne 13th St Dept Veterans, N&fs 120, Oklahoma City, OK 73104-5007 | 2006-09-25 |
| 1811510530 | Bailey Chambers | Dietitian, Registered | 3330 Nw 56th St Ste 500, Oklahoma City, OK 73112-4470 | 2020-05-28 |
| 1518515956 | Well Rooted Health and Nutrition | Dietitian, Registered | 3330 Nw 56th St Ste 608, Oklahoma City, OK 73112-4470 | 2019-08-28 |
| 1962783290 | Lacey Bixler | Dietitian, Registered | 1000 N Lincoln Blvd, Suite 2900, Oklahoma City, OK 73104-3252 | 2011-08-31 |
Please comment or provide details below to improve the information on COMANCHE COUNTY HEALTHCARE CORP.
| 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.