Individual provider Active NPI

Secunda Leah Charlton, APRN-CNP

  • Pediatric Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1497170575
Registry record updated Sep 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
79461 Issued in OK
Practice address
3330 NW 56TH St
Suite 305
Oklahoma City, OK 73112-4479
Phone
(405) 713-7060
Fax
(405) 713-7064
NPI assigned
Feb 26, 2014
Last updated
Sep 26, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 79461 OK Primary

Addresses

Primary practice location

3330 NW 56TH St
Suite 305
Oklahoma City, OK 73112-4479

Mailing address

5300 N Independence Ave
Suite 280
Oklahoma City, OK 73112-5556
Phone (405) 713-7060

Other names 1

  • Mrs. Leah Charlton Other name

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
I20220210000130 OK Practitioner - Nurse Practitioner 2264825595 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79461OKMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ou Health Partners, Inc CurrentSince Sep 9, 2021 Accepting new patients
Ou Health Partners, Inc CurrentSince Sep 9, 2021 Accepting new patients
Ou Medicine Inc. Past Accepting new patients

Locations

1200 Everett Dr
Oklahoma City, OK 73104
Phone (405) 271-2429

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1393372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474848000000",
    "number": "1497170575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE",
            "address_2": "SUITE 280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125556",
            "telephone_number": "405-713-7060",
            "fax_number": "405-713-7064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 NW 56TH ST",
            "address_2": "SUITE 305",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124479",
            "telephone_number": "405-713-7060",
            "fax_number": "405-713-7064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLTON",
        "first_name": "SECUNDA",
        "middle_name": "LEAH",
        "name_prefix": "Mrs.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-26",
        "last_updated": "2016-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OK",
            "license": "79461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEAH",
            "last_name": "CHARLTON",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.