KATHRYN A LEIDECKER (NPI# 1497261002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497261002 |
| Entity Type | Individual |
| Full Name | KATHRYN A LEIDECKER |
| Practice Address |
3024 New Bern Ave Ste 307 Raleigh NC 27610-1247 |
| Mailing Address |
4409 Lazyriver Dr Durham NC 27712-9546 |
| Practice Telephone | 9193507844 |
| Enumeration Date | 2017-12-18 |
| Last Update Date | 2017-12-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
5010107 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3024 NEW BERN AVE STE 307 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27610-1247 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083645477 | Ashish Prabodh Shah | Specialist | 3024 New Bern Ave Ste 307, Raleigh, NC 27610-1247 | 2006-07-05 |
| 1134479454 | Megan Elizabeth Miller | Nurse Practitioner | 3024 New Bern Ave Ste 307, Raleigh, NC 27610-1247 | 2012-09-13 |
| 1235422635 | Gitanjali Madan Fleischman | Otolaryngology | 3024 New Bern Ave Ste 307, Raleigh, NC 27610 | 2011-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609499243 | Elizabeth Ranganai Mavindidze | Social Worker | Wakemed Health and Hospitals, 3000 New Bern Avenue, Raleigh, NC 27610 | 2020-05-18 |
| 1851958839 | Alex & Associates, P.C. | Dentist | 1600 Cross Link Road, Unit 103, Raleigh, NC 27610 | 2019-05-24 |
| 1639646367 | Carol Mary Medins | Dietitian, Registered | Wakemed Raleigh Medical Park, 23 Sunnybrook Road, Suite 200, Raleigh, NC 27610 | 2018-10-31 |
| 1144714601 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 123 Sunnybrook Rd Ste 150, Raleigh, NC 27610 | 2018-06-19 |
| 1417446006 | Eagles Eye Lab, Inc | Clinical Medical Laboratory | 4501 New Bern Ave, Ste: 130, Raleigh, NC 27610 | 2018-05-09 |
| 1316465206 | Jeffery King Neer | Social Worker | 3010 Falstaff Rd., C/o Unc Actt, Raleigh, NC 27610 | 2017-08-31 |
| 1083139885 | Kelsey Daniel Mccleave | Social Worker | 3630 Enduring Freedom Drive, Raleigh, NC 27610 | 2017-08-14 |
| 1891219093 | Tarheel Residential Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4840 Quarryman Road, Raleigh, NC 27610 | 2017-07-29 |
| 1508214826 | Compassionate Care Providers LLC | Respite Care | 5110 Wetlands, Raleigh, NC 27610 | 2016-05-26 |
| 1730552530 | Matthew Belair | Pharmacist | 1601-51 Cross Link Rd, Raleigh, NC 27610 | 2015-11-03 |
| Find all providers in zip 27610 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417558990 | Munira Amirali Ward | Nurse Practitioner | 2617 Valley Haven Dr, Raleigh, NC 27603-3197 | 2020-11-03 |
| 1710598644 | Nicole Dora Licato | Nurse Practitioner | 7200 Creedmoor Rd Ste 208, Raleigh, NC 27613-1711 | 2020-08-13 |
| 1316561178 | Mintoria Lynette Stockton | Nurse Practitioner | 8332 Mcguire Dr, Raleigh, NC 27616-5682 | 2020-06-07 |
| 1700407103 | Sadonna Marlene Sawyer | Nurse Practitioner | 3311 Grove Crabtree Cres Apt 122, Raleigh, NC 27613-3063 | 2020-04-27 |
| 1447879903 | Christapher Frank | Nurse Practitioner | 2034 Wesvill Court, Suite 320, Raleigh, NC 28326 | 2020-04-14 |
| 1265065015 | Shubham Tyagi | Nurse Practitioner | Duke Urgent Care Brier Creek, 10211 Alm Street Suite 1200, Raleigh, NC 27617-2761 | 2020-02-20 |
| 1073163812 | Taylor Brooke Lawrence | Nurse Practitioner | 10208 Cerny St Ste 301, Raleigh, NC 27617-1000 | 2019-09-13 |
| 1811456320 | Elizabeth Campbell Mcgrath | Nurse Practitioner | 2615 Lake Dr Ste 201, Raleigh, NC 27607-6694 | 2019-03-14 |
| 1922578541 | Dorothy Nwizu | Nurse Practitioner | 608 Kavkaz St, Raleigh, NC 27610-3176 | 2018-11-26 |
| 1265900013 | Patricia-marie Edge Odom | Nurse Practitioner | 3000 New Bern Ave Ste G100, Raleigh, NC 27610-1231 | 2018-11-09 |
| Find all providers in RALEIGH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.