Individual provider Active NPI

Leslie Diane Butler, ARNP

  • Family Nurse Practitioner
  • Blanchard, OK
National Provider Identifier
1790752483
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0058298 Issued in OK
Practice address
1019 N Council Ave
Suite 1
Blanchard, OK 73010-8045
Phone
(405) 515-0360
Fax
(405) 307-5596
NPI assigned
Mar 2, 2006
Last updated
Jun 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R0058298 OK Primary

Addresses

Primary practice location

1019 N Council Ave
Suite 1
Blanchard, OK 73010-8045

Mailing address

PO Box 1330
Norman, OK 73070
Phone (405) 307-6630

Other identifiers 1

IdentifierTypeStateIssuer
100130320AMedicaidOK

Other names 1

  • Leslie Diane Richison Former 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
I20031217000715 OK Practitioner - Nurse Practitioner 3577460559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Norman Regional Providers Primary CareGroup PAC ID 5496837718, 56 clinicians

Practice addresses (Care Compare)

1019 N Council Ave
1 Primary Care
Blanchard, OK 73010-8046
Phone (405) 515-0360

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0058298OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Norman Regional Providers Primary Care CurrentSince Nov 1, 2018 Accepting new patients
Summit Medical Center Past Accepting new patients
Norman Regional Hospital Authority Past Accepting new patients

Locations

1019 N Council Ave
Ste 1
Blanchard, OK 73010
Phone (405) 485-9321

2605 SW 119th St
Ste A
Oklahoma City, OK 73170
Phone (405) 912-3100

Interoperability endpoints

  • Direct secure messaging: diane.butler@nrh.eclinicaldirectplus.com

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1790752483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1330",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "73070",
            "telephone_number": "405-307-6630",
            "fax_number": "405-307-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 N COUNCIL AVE",
            "address_2": "SUITE 1",
            "city": "BLANCHARD",
            "state": "OK",
            "postal_code": "730108045",
            "telephone_number": "405-515-0360",
            "fax_number": "405-307-5596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "LESLIE",
        "middle_name": "DIANE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-02",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0058298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100130320A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "RICHISON",
            "middle_name": "DIANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Blanchard, OK

Sources for this page

Verify at the official NPI Registry.