NPIMap

Individual provider Active NPI

Lezlie Duckett, NP-PSYCHIATRY

  • Psychiatric/Mental Health Nurse Practitioner
  • Show Low, AZ
National Provider Identifier
1063542553
Registry record updated Feb 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN130793 Issued in AZ
Practice address
2051 Evergreen LN Ste B
Show Low, AZ 85901-7928
Phone
(928) 537-6841
Fax
(928) 532-2192
NPI assigned
Mar 6, 2007
Last updated
Feb 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN130793 AZ Primary

Addresses

Primary practice location

2051 Evergreen LN Ste B
Show Low, AZ 85901-7928

Mailing address

2051 Evergreen LN Ste B
Show Low, AZ 85901-7928
Phone (928) 537-6841

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050607001370 TX Practitioner - Nurse Practitioner 4183667470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

500 Indiana Ave
Winslow, AZ 86047-2169

500 N Indiana Ave
Winslow, AZ 86047-2169

SWC Navajo Route 15 and 60
1 Medical Center Dr
Dilkon, AZ 86047-2169
Phone (928) 289-4646

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN130793AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Winslow Indian Health Care Center, Inc CurrentSince Aug 22, 2024 Accepting new patients
Winslow Indian Health Care Center, Inc CurrentSince Aug 22, 2024 Accepting new patients
Winslow Indian Health Care Center, Inc. PastSince Jan 1, 1990 Accepting new patients
Winslow Indian Health Care Center, Inc PastSince Jan 1, 1990 Accepting new patients
Winslow Indian Health Care Pharmacy PastSince Jan 1, 1990 Accepting new patients
Winslow Indian Health Care Center, Inc PastSince Jan 1, 1990 Accepting new patients
Winslow Indian Health Care Center, Inc PastSince Jan 1, 1990 Accepting new patients
Winslow Indian Health Care Center, Inc PastSince Jan 1, 1990 Accepting new patients
Winslow Indian Health Care Center, Inc PastSince Jan 1, 1990 Accepting new patients
Winslow Indian Health Care Center, Inc PastSince Jan 1, 1990 Accepting new patients
Dilkon Medical Center Pharmacy PastSince Jan 1, 1990 Accepting new patients
Winslow Indian Health Care Center, Inc PastSince Jan 1, 1990 Accepting new patients
Winslow Indian Health Care Center, Inc PastSince Jan 1, 1990 Accepting new patients

Locations

1501 N Williamson Ave
Winslow, AZ 86047
Phone (928) 289-4691

500 Indiana Ave
Winslow, AZ 86047

826 W Desmond St
Winslow, AZ 86047
Phone (928) 289-4678

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675555200000",
    "number": "1063542553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 EVERGREEN LN STE B",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017928",
            "telephone_number": "928-537-6841",
            "fax_number": "928-532-2192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 EVERGREEN LN STE B",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017928",
            "telephone_number": "928-537-6841",
            "fax_number": "928-532-2192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCKETT",
        "first_name": "LEZLIE",
        "credential": "NP-PSYCHIATRY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2023-02-05",
        "certification_date": "2023-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "RN130793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Show Low, AZ

Sources for this page

Verify at the official NPI Registry.