Wildstate Lawton LLC
NPI 1467327759 · Clinic/Center · Lawton, OK
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Wildstate Lawton LLC is a Clinic/Center organization in Lawton, OK (NPI 1467327759).
Provider details
- NPI number
- 1467327759
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Crystal Johnson, Owner(580) 280-2558
Specialties & taxonomies
Ambulatory Health Care Facilities
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 2504 Sw Lee BlvdLawton, OK 73505-8311Phone: (580) 250-1999Fax: (580) 353-9533
Registry dates
- Enumerated
- 2025-10-07
- Last updated
- 2025-10-20
- Certified
- 2025-10-20
Frequently asked questions
- What is Wildstate Lawton LLC's NPI number?
- Wildstate Lawton LLC's National Provider Identifier (NPI) is 1467327759, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Wildstate Lawton LLC?
- Wildstate Lawton LLC is classified in the NPPES registry as Clinic/Center (Ambulatory Health Care Facilities).
- Where is Wildstate Lawton LLC located?
- Wildstate Lawton LLC's practice location on file with NPPES is 2506 Sw Lee Blvd, Lawton, OK 73505-8311.
- What is Wildstate Lawton LLC's phone number?
- The practice phone number listed in the NPPES registry for Wildstate Lawton LLC is (580) 280-2558.
- Does Wildstate Lawton LLC accept Medicare?
- Wildstate Lawton LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Wildstate Lawton LLC?
- The authorized official listed on Wildstate Lawton LLC's NPPES record is Crystal Johnson, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Wildstate Lawton LLC's NPI active?
- Yes — Wildstate Lawton LLC's NPI (1467327759) is active in the NPPES registry as of the last update on 2025-10-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.