Individual provider Active NPI

Leisha Lawson

  • Family Nurse Practitioner
  • Broken Arrow, OK
National Provider Identifier
1326519349
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0083197 Issued in OK
Practice address
1130 E Lansing St Ste B
Broken Arrow, OK 74012-2429
Phone
(918) 258-9111
NPI assigned
Dec 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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 R0083197 OK Primary

Addresses

Primary practice location

1130 E Lansing St Ste B
Broken Arrow, OK 74012-2429

Mailing address

1130 E Lansing St Ste B
Broken Arrow, OK 74012-2429
Phone (918) 258-9111

Other names 1

  • Leisha Vaughn Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, OK2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190509000242 KS Practitioner - Nurse Practitioner 9436491602
I20211029001754 OK Practitioner - Nurse Practitioner 9436491602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Oklahoma Physician Network IncGroup PAC ID 8527224252, 11 clinicians

Practice addresses (Care Compare)

1130 E Lansing
Suite a
Broken Arrow, OK 74012-2429
Phone (918) 258-9990

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Oklahoma Physician Network Inc CurrentSince Apr 8, 2022 Accepting new patients
Northeast Oklahoma Physician Network Inc CurrentSince Apr 8, 2022 Accepting new patients

Locations

1130 E Lansing St
Ste A
Broken Arrow, OK 74012
Phone (918) 258-9990

1130 E Lansing St
Ste B
Broken Arrow, OK 74012
Phone (918) 258-9111

1130 E Lansing St
Broken Arrow, OK 74012
Phone (918) 258-9111

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIHBDD

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1326519349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 E LANSING ST STE B",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122429",
            "telephone_number": "918-258-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 E LANSING ST STE B",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122429",
            "telephone_number": "918-258-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWSON",
        "first_name": "LEISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-17",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0083197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEISHA",
            "last_name": "VAUGHN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Broken Arrow, OK

Sources for this page

Verify at the official NPI Registry.