Leonard Udel Lacefield III

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

5651 Issued in OK

Practice address

717 S Houston Ave Ste 310
Tulsa, OK 74127-9023

Phone

(918) 382-5064

Fax

(918) 382-3589

NPI assigned

Feb 19, 2013

Last updated

Feb 14, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Beau Lacefield Other name

Medicare fee-for-service enrollment

Enrolled in OK, LA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: leeonard.lacefield.p4@direct.ctca-clinic.nextgenshare.com
• Direct secure messaging: llacefield270373@ahs.direct-ci.com

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

• Cleveland Area Hospital Holdings, Inc.

  dba Cleveland Area Hospital Professional Services

  • Emergency Medical Services (Emergency Medicine) Physician
  • Cleveland, OK
  • NPI 1801020565
  Medicare reassignment NPD
• Oklahoma State University

  dba OSU Speech-Language-Hearing Clinic

  • Speech-Language Pathologist
  • Stillwater, OK
  • NPI 1700994878
  Medicare reassignment NPD
• Tulsa Hospital Medicine Physicians Group, LLC

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1144982711
  Medicare reassignment NPD
• LC Hospital Medicine Physicians, LLC

  • Internal Medicine Physician
  • Lake Charles, LA
  • NPI 1417654724
  Medicare reassignment NPD
• Cleveland Area Hospital Holdings, Inc.

  dba Lake Area Medical Associates

  • Rural Health Clinic/Center
  • Cleveland, OK
  • NPI 1588160774
  NPD
• Oklahoma State University

  dba OSU Physicians Clinical Laboratory

  • Clinical Medical Laboratory
  • Tulsa, OK
  • NPI 1326495433
  NPD
• Cleveland Area Hospital Holdings, Inc.

  dba Cleveland Area Hospital

  • Critical Access Hospital
  • Cleveland, OK
  • NPI 1427295872
  NPD (past)

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

{
    "created_epoch": "1361232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1447590088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 S HOUSTON AVE STE 310",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741279023",
            "telephone_number": "918-382-5064",
            "fax_number": "918-382-3589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 S HOUSTON AVE STE 310",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741279023",
            "telephone_number": "918-382-5064",
            "fax_number": "918-382-3589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACEFIELD",
        "first_name": "LEONARD",
        "middle_name": "UDEL",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-19",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "DO177881",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "5651",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34.012139",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "OP60641490",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200542440A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEAU",
            "last_name": "LACEFIELD",
            "credential": "D.0.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rebekah J Labouff, APRN, CPNP-PC
• Kay Lynn Labranche
• Mason Labranche
• Lauren Labryer, MD
• Ronald S. Labutti, D.O.
• Patricia Gregg Lacey, ARNP
• Kelsey Lackey, PHARMD
• Madison Dale Lackey
• Makalie Grace Lackey
• Stacy Lackey, M.S.

• Internal Medicine Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Internal Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.