REYNOLDS ARMY COMMUNITY HOSPITAL (NPI# 1821318668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821318668 |
| Entity Type | Organization |
| Organization Name | REYNOLDS ARMY COMMUNITY HOSPITAL |
| Other Organization Name | FRONTIER MEDICAL HOME-SILL |
| Practice Address |
5404 Sw Lee Blvd Frontier Medical Home-sill Lawton OK 73505-9695 |
| Mailing Address |
3009 Nw Wilson Street Attn Mcua-pad-pf - Billing Office Fort Sill OK 73503 |
| Practice Telephone | 5805582800 |
| Mailing Telephone | 5804582793 |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2014-02-26 |
| Authorized Official Name | CHARLES CHITTUM (UBO MANAGER) |
| Authorized Official Telephone | 5805582793 |
| Is Organization Subpart | Y |
| Parent Organization Name | REYNOLDS ARMY COMMUNITY HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1100X |
Clinic/Center Specialization: Military/U.S. Coast Guard Outpatient |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PARENT FACILITY NPI 2 | 1487752960 | 01 |
| Other Name | Type Code |
|---|---|
| FRONTIER MEDICAL HOME-SILL | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912377649 | Reynolds Army Community Hospital | Clinic/Center | 3161 Hoskins Rd, Fort Sill, OK 73503-4462 | 2015-10-07 |
| 1740650464 | Reynolds Army Community Hospital | Clinic/Center | 3445 Koehler Loop, Fort Sill, OK 73503-6008 | 2015-10-07 |
| 1932480068 | Reynolds Army Community Hospital | Clinic/Center | 2640 Miner Rd, Fort Sill, OK 73503 | 2011-09-02 |
| 1457654766 | Reynolds Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Custer Road, Bldg 2913, Fort Sill, OK 73503 | 2010-12-08 |
| 1427208008 | Reynolds Army Community Hospital | Clinic/Center | 2913 Craig Road, Fort Sill, OK 73503 | 2008-09-19 |
| 1760688220 | Reynolds Army Community Hospital | Clinic/Center | 2862 Craig Road, Fort Sill, OK 73503 | 2007-06-22 |
| 1881890358 | Reynolds Army Community Hospital | Clinic/Center | 605 Randolph Road, Fort Sill, OK 73503 | 2007-06-22 |
| 1699971143 | Reynolds Army Community Hospital | Clinic/Center | 6037 Bessinger Street, Fort Sill, OK 73503 | 2007-06-22 |
| 1023117066 | Reynolds Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 10020 Kabrich Cir, Pine Bluff, AR 71602-9031 | 2006-09-22 |
| 1831298017 | Reynolds Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Macomb Rd Bldg 1719, Ft Sill, OK 73503 | 2006-09-22 |
| Street Address |
5404 SW LEE BLVD FRONTIER MEDICAL HOME-SILL |
| City | LAWTON |
| State | OK |
| Zip Code | 73505-9695 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689678245 | Richard Jene Allgood | Surgery | 5404 Sw Lee Blvd, Lawton, OK 73505-9521 | 2005-06-10 |
| 1942782040 | Comanche County Hospital Authority | Pharmacy | 5404 Sw Lee Blvd, Lawton, OK 73505-9521 | 2018-09-05 |
| 1366922437 | April Zumwalt | Nurse Practitioner | 5404 Sw Lee Blvd, Lawton, OK 73505-9521 | 2018-08-17 |
| 1659871044 | Michelle White | Registered Nurse | 5404 Sw Lee Blvd, Lawton, OK 73505-9695 | 2018-02-13 |
| 1154859189 | Natalie Patterson | Student in an Organized Health Care Education/Training Program | 5404 Sw Lee Blvd, Lawton, OK 73505-9695 | 2017-06-04 |
| 1427401686 | Jennifer Cargill | Nurse Practitioner | 5404 Sw Lee Blvd, Lawton, OK 73505-9695 | 2016-07-22 |
| 1073928594 | Phong Luu | Family Medicine | 5404 Sw Lee Blvd, Lawton, OK 73505-9695 | 2014-06-23 |
| 1427481449 | Ahmed Mohamed Abdin | Pediatrics | 5404 Sw Lee Blvd, Lawton, OK 73505-9695 | 2013-08-13 |
| 1932540440 | Chasity Maureen Landtroop | Counselor | 5404 Sw Lee Blvd, Lawton, OK 73505-9695 | 2013-07-12 |
| 1447543285 | Lawton Surgery Investment Company LLC | Clinic/Center | 5404 Sw Lee Blvd, Lawton, OK 73505-9695 | 2011-05-26 |
| 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 | 261QM1100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Military/U.S. Coast Guard Outpatient |
| The Defense Health Program or U.S. Coast Guard funded "fixed" facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A "fixed" facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the "fixed" facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport. |
| Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: title modified, definition added; 7/1/2006 title modified, definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912377649 | Reynolds Army Community Hospital | Clinic/Center | 3161 Hoskins Rd, Fort Sill, OK 73503-4462 | 2015-10-07 |
| 1740650464 | Reynolds Army Community Hospital | Clinic/Center | 3445 Koehler Loop, Fort Sill, OK 73503-6008 | 2015-10-07 |
| 1932480068 | Reynolds Army Community Hospital | Clinic/Center | 2640 Miner Rd, Fort Sill, OK 73503 | 2011-09-02 |
| 1427208008 | Reynolds Army Community Hospital | Clinic/Center | 2913 Craig Road, Fort Sill, OK 73503 | 2008-09-19 |
| 1760688220 | Reynolds Army Community Hospital | Clinic/Center | 2862 Craig Road, Fort Sill, OK 73503 | 2007-06-22 |
| 1881890358 | Reynolds Army Community Hospital | Clinic/Center | 605 Randolph Road, Fort Sill, OK 73503 | 2007-06-22 |
| 1699971143 | Reynolds Army Community Hospital | Clinic/Center | 6037 Bessinger Street, Fort Sill, OK 73503 | 2007-06-22 |
| 1083810550 | Reynolds Army Community Hospital | Clinic/Center | 4301 Mow Way Road, Fort Sill, OK 73503 | 2007-06-22 |
| 1124234364 | Reynolds Army Community Hospital | Clinic/Center | 4301 Mow Way Road, Sgt Bleak Troop Medical Clinic, Fort Sill, OK 73503 | 2007-05-15 |
| 1174738124 | Reynolds Army Community Hospital | Clinic/Center | 1 C Tree Rd, Mcalester, OK 74501-9002 | 2007-05-12 |
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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.