Organization Active NPI

Leslie a. Faulkner, O.D. PLLC

Doing business as EyeCare of Bartlesville

  • Optometrist
  • Bartlesville, OK
National Provider Identifier
1093123846
Registry record updated Jul 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2810 Issued in OK
Legal business name
LESLIE A. FAULKNER, O.D. PLLC
Doing business as
EyeCare of Bartlesville
Practice address
311 SE Delaware Ave
Bartlesville, OK 74003-3631
Phone
(918) 336-0607
NPI assigned
Jul 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2014

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

Authorized official

Name
Leslie Faulkner, ODNPI 1255748877
Title
Owner
Phone
(918) 336-0607

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2810 OK Primary

Addresses

Primary practice location

311 SE Delaware Ave
Bartlesville, OK 74003-3631

Mailing address

311 SE Delaware Ave
Bartlesville, OK 74003-3631
Phone (918) 336-0607

Other names 1

  • EyeCare of Bartlesville Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140808001012 OK Part B Supplier - Clinic/Group Practice 5991922320 Receives reassigned benefits from 1 practitioner
Practice locations: Bartlesville, OK

National Provider Directory

National Provider Directory

Locations

311 SE Delaware Ave
Bartlesville, OK 74003
Phone (918) 336-0607

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1406160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406160000000",
    "number": "1093123846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 SE DELAWARE AVE",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740033631",
            "telephone_number": "918-336-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 SE DELAWARE AVE",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740033631",
            "telephone_number": "918-336-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LESLIE A. FAULKNER, O.D. PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-24",
        "last_updated": "2014-07-24",
        "status": "A",
        "authorized_official_last_name": "FAULKNER",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-336-0607",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EyeCare of Bartlesville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bartlesville, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.