Individual provider Active NPI

Lesa Roy, AUD

  • Audiologist
  • Bartlesville, OK
National Provider Identifier
1669048179
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
6020 Issued in OK
Practice address
205 SE Howard Ave
Bartlesville, OK 74006-2204
Phone
(918) 333-0474
Fax
(918) 333-5225
NPI assigned
Jun 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A-2993 NV
Audiologist 231H00000X
Audiologist 231H00000X 6020 OK Primary

Addresses

Primary practice location

205 SE Howard Ave
Bartlesville, OK 74006-2204

Mailing address

205 SE Howard Ave
Bartlesville, OK 74006-2204
Phone (918) 333-0474

Other practice location 1

9005 S Pecos Rd Ste 2520
Henderson, NV 89074-7191
Phone (702) 818-5000

Other practice location 2

401 N Buffalo Dr Ste 120
Las Vegas, NV 89145-0397
Phone (702) 818-5000

Other practice location 3

11545 N Frank Lloyd Wright Blvd Apt 2161
Scottsdale, AZ 85259-3187
Phone (918) 809-1653

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230829002302 OK Practitioner - Qualified Audiologist 8123428158 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A-2993NVMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc. Current Accepting new patients
St. John Physicians, Inc CurrentSince Jul 16, 2023 Accepting new patients

Locations

3500 E Frank Phillips Blvd
Bartlesville, OK 74006
Phone (918) 331-1555

205 SE Howard Ave
Bartlesville, OK 74006
Phone (918) 333-0474

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

Organizations & group practices 2

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": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1669048179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 SE HOWARD AVE",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740062204",
            "telephone_number": "918-333-0474",
            "fax_number": "918-333-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 SE HOWARD AVE",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740062204",
            "telephone_number": "918-333-0474",
            "fax_number": "918-333-5225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9005 S Pecos Rd Ste 2520",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890747191",
            "country_code": "US",
            "telephone_number": "702-818-5000",
            "fax_number": "702-818-5001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 N Buffalo Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891450397",
            "country_code": "US",
            "telephone_number": "702-818-5000",
            "fax_number": "702-818-5001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11545 N Frank Lloyd Wright Blvd Apt 2161",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852593187",
            "country_code": "US",
            "telephone_number": "918-809-1653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROY",
        "first_name": "LESA",
        "credential": "AUD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-03",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NV",
            "license": "A-2993",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OK",
            "license": "6020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlesville, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.