Individual provider Active NPI

Molly Leblanc, DPT

  • Physical Therapist
  • Tulsa, OK
National Provider Identifier
1366001174
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5630 Issued in OK
Practice address
7401 Riverside Pkwy Unit 219
Tulsa, OK 74136-5057
Phone
(918) 216-9303
Fax
(539) 202-5007
NPI assigned
Jun 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5630 OK Primary

Addresses

Primary practice location

7401 Riverside Pkwy Unit 219
Tulsa, OK 74136-5057

Mailing address

5819 Hefner Village Cir
Oklahoma City, OK 73162-7757
Phone (775) 857-7907

Other practice location 1

1300 S Country Club Rd
El Reno, OK 73036-5304
Phone (405) 422-1291

Other names 1

  • Molly Moran Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190809002034 OK Practitioner - Physical Therapist in Private Practice 9638406895

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5630OKMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Mobile Health Care Physical Therapist CurrentSince Dec 12, 2023 Accepting new patients

Organizations & group practices 1

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": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1366001174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5819 HEFNER VILLAGE CIR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731627757",
            "telephone_number": "775-857-7907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7401 RIVERSIDE PKWY UNIT 219",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741365057",
            "telephone_number": "918-216-9303",
            "fax_number": "539-202-5007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 S Country Club Rd",
            "address_purpose": "LOCATION",
            "city": "El Reno",
            "state": "OK",
            "postal_code": "730365304",
            "country_code": "US",
            "telephone_number": "405-422-1291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "MOLLY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-06",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "5630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "MORAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.