Active NPI
Bruce Ray Leach, P.T.
- Physical Therapist
- Norman, OK
National Provider Identifier
1114268018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 819
- Practice address
- 724 24TH Ave., N.W.
Suite 100
Norman, OK 73069 - Phone
- (405) 447-1571
- Fax
- (405) 447-1579
- NPI assigned
- Mar 4, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 819 | OK | Primary |
Addresses
Primary practice location
724 24TH Ave., N.W.
Suite 100
Norman, OK 73069
Mailing address
724 24TH Ave., N.W.
Suite 100
Norman, OK 73069
Phone (405) 447-1571
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 819 | OK | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362355200000",
"number": "1114268018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "724 24TH AVE., N.W.",
"address_2": "SUITE 100",
"city": "NORMAN",
"state": "OK",
"postal_code": "73069",
"telephone_number": "405-447-1571",
"fax_number": "405-447-1579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "724 24TH AVE., N.W.",
"address_2": "SUITE 100",
"city": "NORMAN",
"state": "OK",
"postal_code": "73069",
"telephone_number": "405-447-1571",
"fax_number": "405-447-1579"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEACH",
"first_name": "BRUCE",
"middle_name": "RAY",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-03-04",
"last_updated": "2013-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "819",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norman, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.