Beth Lee Leader, DO
Individual provider Active NPI General Practice Physician · Antlers, OK
NPI 1891786737 · NPPES record last updated Apr 17, 2012
Key facts
- NPI
- 1891786737
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 2795 (OK)
- Practice address
- 603 NE 2ND St
Rowland Flatt Clinic
Antlers, OK 74523-2636 - Phone
- (580) 298-3351
- Fax
- (580) 298-3803
- NPI assigned
- Oct 31, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- General Practice
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kiamichi Family Medical Center Inc.
Practice addresses (Care Compare)
403 S Indian Rd
Idabel, OK 74745-5458
Phone 5802866688140
510 S Park Dr
Broken Bow, OK 74728-5330
Phone (580) 286-6688
6026 Battiest Pickens Rd
Broken Bow, OK 74728-5033
Phone 5802866688149
Hospital & facility affiliations
- Mays Housecall Home Health of Antlers, LLC
- Enhabit Home Health of Southeast Oklahoma
- Mena Regional Health System
- Paris Regional Medical Center
- McCurtain Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100208000399 | OK | Practitioner - General Practice | 2567505969 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2795 | OK | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kiamichi Family Medical Center Inc. | Current |
Accepting new patients | |
| Kiamichi Family Medical Center, Inc | Current |
Accepting new patients | |
| Rowland Ellis Flatt Hugo Rural Health Clinic | Past | Accepting new patients | |
| Kiamichi Family Medical Center, Inc | Past |
Accepting new patients | |
| R E F M Emergency Services | Past | Accepting new patients | |
| Mena Hospital Commission | Past | Accepting new patients |
Locations
601 E Washington St
Idabel, OK 74745
Phone (580) 286-6688
2809 NE Lincoln Rd
Idabel, OK 74745
Phone (580) 286-6688
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/GDGBBA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 2795 | OK | Yes |
Addresses
Primary practice location
603 NE 2ND St
Rowland Flatt Clinic
Antlers, OK 74523-2636
Mailing address
603 NE 2ND St
Antlers, OK 74523-2636
Phone (580) 298-3351
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100124300B | Medicaid | OK |
Other providers in Antlers, OK
- Mattie Langford
- Tammie Renee Langford
- Kelly Langley
- Wanda L Lassiter
- Chance J Lawless
- Michael R Leonard
- Angela Kay Lindly
- La Fawn N Little
- Jeffrey Loving
- Ambra Mack
All providers in Antlers, OK · General Practice Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.