Individual provider Active NPI

Cynthia Renee Leatherwood, APRN, FNP-BC

  • Family Nurse Practitioner
  • Poteau, OK
National Provider Identifier
1346993441
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
206451 Issued in OK
Practice address
105 Wall St
Poteau, OK 74953-4433
Phone
(918) 647-8161
NPI assigned
Jan 28, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 206451 OK Primary

Addresses

Primary practice location

105 Wall St
Poteau, OK 74953-4433

Mailing address

40048 Round MTN Rd
Howe, OK 74940-5002
Phone (918) 385-1595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220223000753 OK Practitioner - Nurse Practitioner 5092109702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leflore County Hospital Authority 16 clinicians

Practice addresses (Care Compare)

104 Wall St
Eastern Oklahoma Medical Center
Poteau, OK 74953-4405
Phone (918) 647-8161

Hospital & facility affiliations

  • Mays Housecall Home Health of Tulsa, LLC Home health agency, Tulsa, OK, CCN 377691
  • Heritage Home Care, Inc Home health agency, Eufaula, OK, CCN 377872
  • Compassion Home Care, Inc. Home health agency, Stigler, OK, CCN 377740
  • Eastern Oklahoma Medical Center Hospital, Poteau, OK, CCN 371337

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Leflore County Hospital Authority CurrentSince Feb 1, 2022 Accepting new patients
Leflore County Hospital Authority Single Specialty CurrentSince Feb 1, 2022 Accepting new patients
Leflore County Hospital Authority Past Accepting new patients

Locations

304 Highway 59 N
Heavener, OK 74937
Phone (918) 653-2918

105 Wall St
Poteau, OK 74953
Phone (918) 635-3100

1013 Dewey Ave
Poteau, OK 74953
Phone (918) 647-2929

104 Wall St
Poteau, OK 74953
Phone (918) 635-3578

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 and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1643328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1346993441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40048 ROUND MTN RD",
            "city": "HOWE",
            "state": "OK",
            "postal_code": "749405002",
            "telephone_number": "918-385-1595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WALL ST",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749534433",
            "telephone_number": "918-647-8161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEATHERWOOD",
        "first_name": "CYNTHIA",
        "middle_name": "RENEE",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-28",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "206451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poteau, OK

Sources for this page

Verify at the official NPI Registry.