Stephanie Diane Burleson, D.O.
Individual provider Active NPI Family Medicine Physician · Bixby, OK
NPI 1457556474 · NPPES record last updated Oct 15, 2012
Key facts
- NPI
- 1457556474
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 4280 (OK)
- Practice address
- 11911 S Memorial Dr
Bixby, OK 74008-2030 - Phone
- (918) 497-3700
- NPI assigned
- Jun 19, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Oklahoma State University College of Osteopathic Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Warren Clinic Inc
Practice addresses (Care Compare)
6600 S Yale Ave
Suite 1400
Tulsa, OK 74136-3331
Phone (918) 488-6000
Hospital & facility affiliations
- Saint Francis Home Health
- Saint Francis Hospital, Inc
- Saint Francis Hospital South, LLC
- Saint Francis Hospital Muskogee
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071018000102 | OK | Practitioner - Family Practice | 5597851899 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4280 | OK | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Warren Clinic Inc | Current |
Accepting new patients | |
| Ahs Oklahoma Physician Group LLC | Family Medicine | Past | Accepting new patients |
Locations
6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045
10506 S Memorial Dr
Tulsa, OK 74133
Phone (918) 369-3200
6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125
Interoperability endpoints
- sburleson7665@direct.saintfrancis.com
- https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4280 | OK | Yes |
Addresses
Primary practice location
11911 S Memorial Dr
Bixby, OK 74008-2030
Mailing address
6600 S Yale Ave
Suite 1400
Tulsa, OK 74136-3347
Phone (918) 488-6001
Other names
- Stephanie Diane Proctor
Other providers in Bixby, OK
- Julie Vang Broaddrick
- Brookshire Grocery Company
- Michael T Brummert
- Brush Dentistry LLC
- Amber Dawn Burdette
- Casey Marie Cale
- Careatc - Bixby
- Katie Cariker
- Kaylor Carlton
- Carter Healthcare DME of Northeast Oklahoma LLC
All providers in Bixby, OK · Family Medicine Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.