Active NPI
Leslie Nicole Agnew, PTA
- Physical Therapy Assistant
- Tulsa, OK
National Provider Identifier
1497339733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 1449
- Practice address
- 1815 E Skelly Dr
Tulsa, OK 74105-5949 - Phone
- (918) 747-4193
- NPI assigned
- May 12, 2021
- Last updated
- May 12, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 1449 | OK | Primary |
Addresses
Primary practice location
1815 E Skelly Dr
Tulsa, OK 74105-5949
Mailing address
1392 E 171St St N
Skiatook, OK 74070-3121
Phone (918) 798-6733
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PTA-1449 | Other | OK | OKLAHOMA PTA LICENSURE |
Other names 1
- Leslie Nicole Day
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1449 | OK | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620777600000",
"number": "1497339733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1392 E 171ST ST N",
"city": "SKIATOOK",
"state": "OK",
"postal_code": "740703121",
"telephone_number": "918-798-6733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1815 E SKELLY DR",
"city": "TULSA",
"state": "OK",
"postal_code": "741055949",
"telephone_number": "918-747-4193"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGNEW",
"first_name": "LESLIE",
"middle_name": "NICOLE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-12",
"last_updated": "2021-05-12",
"certification_date": "2021-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OK",
"license": "1449",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OKLAHOMA PTA LICENSURE",
"identifier": "PTA-1449",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LESLIE",
"last_name": "DAY",
"middle_name": "NICOLE",
"credential": "PTA",
"code": "5",
"type": "Other 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 May 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.