Lesli Bullock

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

119449 Issued in OK

Practice address

14100 Parkway Commons Dr Ste 201
Oklahoma City, OK 73134-6104

Phone

(405) 749-2765

Fax

(405) 749-6209

NPI assigned

Mar 27, 2009

Last updated

Jan 26, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Nurse Practitioner

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jack E. Marshall M.D. LLCGroup PAC ID 6901044346, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Oklahoma Spine Hospital Hospital, Oklahoma City, OK, CCN 370206

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19094/brand/1/csg/1/fhir/r4
• Direct secure messaging: lesli.bullock@1374.securemail.prognocis.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.

• Osh Pain Management Associates, LLC

  • Interventional Pain Medicine Physician
  • Oklahoma City, OK
  • NPI 1568701332
  Medicare reassignment Care Compare group NPD
• Orthopedic Spine Associates

  • Orthopaedic Surgery of the Spine Physician
  • Oklahoma City, OK
  • NPI 1568934859
  Medicare reassignment NPD
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)
• Alabama Orthopaedic Clinics, PC

  • Specialist
  • Mobile, AL
  • NPI 1306846654
  NPD (past)
• Coastal Anesthesia, P.C.

  • Anesthesiology Physician
  • Mobile, AL
  • NPI 1588637169
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Oklahoma Spine Hospital LLC

  dba Oklahoma Spine Hospital

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1699745893
  Care Compare affiliation

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

{
    "created_epoch": "1238112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1568604197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14100 PARKWAY COMMONS DR STE 201",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731346104",
            "telephone_number": "405-749-2765",
            "fax_number": "405-749-6209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14100 PARKWAY COMMONS DR STE 201",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731346104",
            "telephone_number": "405-749-2765",
            "fax_number": "405-749-6209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "LESLI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-27",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "119449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112840",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568604197",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna Bullen
• Andrew N. M. Bulley
• Yvonne M Bullion, TRIAGE SPECIALIST
• Sarah Bulloch
• Amy Carolyn Bullock
• Michelle Starr Bullock
• Owen Bullock
• Peter Paul Bullock Jr., M.D.
• Benjamin Myles Bumgarner
• Cynthia Bunch

• Nurse Practitioner in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.