IVANKA A VASSILEVA (NPI# 1295729929) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295729929 |
| Entity Type | Individual |
| Full Name | IVANKA A VASSILEVA |
| Credential | MD |
| Practice Address |
4411 W Gore Blvd Ste B10 Lawton OK 73505-5977 |
| Practice Telephone | 5803549600 |
| Practice Fax Number | 5803549621 |
| Mailing Telephone | 5803549600 |
| Mailing Fax Number | 5803549621 |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2012-02-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 22970 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200055900A | 05 |
| Street Address |
4411 W GORE BLVD STE B10 |
| City | LAWTON |
| State | OK |
| Zip Code | 73505-5977 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891195590 | Comanche County Healthcare Corporation | Nurse Practitioner | 4411 W Gore Blvd, Suite A2, Lawton, OK 73505-6016 | 2014-08-29 |
| 1003151739 | Niina Irene Tucker | Behavioral Analyst | 4411 W Gore Blvd, Lawton, OK 73505-5977 | 2012-12-06 |
| 1659624427 | Sammie Lea Forrester | Counselor | 4411 W Gore Blvd, Lawton, OK 73505-5977 | 2012-10-18 |
| 1801151097 | Maurice Demarco Horton | Counselor | 4411 W Gore Blvd, Ste B8, Lawton, OK 73505-5977 | 2012-07-12 |
| 1699037820 | Oak Tree Counseling Services | Behavioral Analyst | 4411 W Gore Blvd, Lawton, OK 73505-5977 | 2012-06-13 |
| 1225398332 | Bernice Jaria | Counselor | 4411 W Gore Blvd, Suite B8, Lawton, OK 73505-5977 | 2012-05-22 |
| 1922365725 | Verneka Eaoshea Bullard | Social Worker | 4411 W Gore Blvd, Suite B8, Lawton, OK 73505-5977 | 2012-04-18 |
| 1346545944 | Francois J Du Toit, Md, LLC | Family Medicine | 4411 W Gore Blvd, B6, Lawton, OK 73505-5977 | 2011-01-13 |
| 1902058050 | Amber Leigh Morrow | Nurse Practitioner | 4411 W Gore Blvd, Suite A2, Lawton, OK 73505-6016 | 2008-10-21 |
| 1053561878 | R. Brent Smith, M.d., Inc. | Family Medicine | 4411 W Gore Blvd, Ste. B-5, Lawton, OK 73505-5977 | 2008-09-29 |
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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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629604376 | Comanche County Healthcare Corporation | Family Medicine | 3201 W Gore Blvd Ste G1, Lawton, OK 73505-6308 | 2020-03-13 |
| 1578008827 | Acellerated Interventional Orthopedics | Family Medicine | 5370 Nw Cache Rd Ste 4, Lawton, OK 73505-3371 | 2016-12-22 |
| 1760838445 | Samms LLC | Family Medicine | 1222 Nw Cache Rd, Lawton, OK 73507-4036 | 2016-05-11 |
| 1164804837 | Xpress Wellness LLC | Family Medicine | 6744 Nw Cashe Road, Lawton, OK 73505 | 2015-06-18 |
| 1225416720 | Anson Lukose | Family Medicine | 5606 Sw Lee Blvd Ste 304, Lawton, OK 73505-9618 | 2015-05-15 |
| 1275911885 | Ilona Yurfeld | Family Medicine | 3201 W Gore Blvd Ste 301, Lawton, OK 73505 | 2015-05-14 |
| 1467765941 | Mayank Dave Mdpc | Family Medicine | 5606 Sw Lee Blvd Ste 202, Lawton, OK 73505-9689 | 2010-07-26 |
| 1972631067 | Daryl E. Birdwell, M.d., Inc. | Family Medicine | 4417 W Gore Blvd Ste 2, Lawton, OK 73505-5978 | 2007-03-01 |
| 1073693917 | John C Loose | Family Medicine | 3201 W Gore Blvd Ste 305, Memorial Medical Group, Lawton, OK 73505-6350 | 2006-10-16 |
| 1891718631 | Donnie S Beasley | Family Medicine | 310 White Oak Rd, Lawton, MI 49065-9705 | 2006-07-25 |
| Find all providers in LAWTON | ||||
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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.