Individual provider Active NPI

Leisha Monette Blaylock, FNP-C

  • Family Nurse Practitioner
  • Denton, TX
National Provider Identifier
1083018063
Registry record updated Feb 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP126686 Issued in TX
Practice address
3537 S Interstate 35 E Ste 200
Denton, TX 76210-6814
Phone
(940) 800-2565
Fax
(833) 269-3376
NPI assigned
Oct 20, 2014
Last updated
Feb 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP126686 TX Primary

Addresses

Primary practice location

3537 S Interstate 35 E Ste 200
Denton, TX 76210-6814

Mailing address

325 N Saint Paul St Ste 3100
Dallas, TX 75201-3923
Phone (888) 731-8994

Other identifiers 2

IdentifierTypeStateIssuer
8397NMOtherTXBCBS
342225501MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP126686TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Decatur Hospital Authority Current Accepting new patients
Wise Clinical Care Associates Past Accepting new patients
Expert Surgical, PLLC Past Accepting new patients
Decatur Hospital Authority PastSince Oct 21, 2014 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: leishablaylock@wise.allscriptsdirect.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1413763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771718400000",
    "number": "1083018063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 N SAINT PAUL ST STE 3100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752013923",
            "telephone_number": "888-731-8994",
            "fax_number": "999-999-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3537 S INTERSTATE 35 E STE 200",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762106814",
            "telephone_number": "940-800-2565",
            "fax_number": "833-269-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAYLOCK",
        "first_name": "LEISHA",
        "middle_name": "MONETTE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-20",
        "last_updated": "2026-02-22",
        "certification_date": "2026-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP126686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8397NM",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "342225501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.