LESLIE A RICHARDSON (NPI# 1780604751) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780604751 |
| Entity Type | Individual |
| Full Name | LESLIE A RICHARDSON |
| Credential | M.D. |
| Practice Address |
100 Brewster Blvd Camp Lejeune NC 28547-2575 |
| Practice Telephone | 9104503712 |
| Practice Fax Number | 9104503766 |
| Mailing Telephone | 9104503712 |
| Mailing Fax Number | 9104503766 |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2018-02-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 95-00703 | NC | Allopathic & Osteopathic Physicians |
| Y | 2080P0006X |
Pediatrics Specialization: Developmental – Behavioral Pediatrics |
95-00703 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | NC2600 | 05 | |
| NC | 8971547 | 05 | |
| NC | 1780604751 | 05 | |
| NC | NCBCBS | 71547 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013429547 | Leslie Richardson | Counselor | 801 E Broad Ave Ste 12, Rockingham, NC 28379-4382 | 2017-10-24 |
| 1558508796 | Leslie Ann Richardson | Massage Therapist | 7101 Wandering Oak Rd, Austin, TX 78749-1892 | 2009-01-09 |
| 1609159664 | Leslie Richardson | Counselor | 4510 Frankford Ave, 2nd Floor, Philadelphia, PA 19124-3602 | 2011-09-26 |
| 1891924296 | Leslie Joan Richardson | Physical Therapist | 245 Cahaba Valley Pkwy, Suite 200, Pelham, AL 35124-2216 | 2009-07-07 |
| 1245488808 | Leslie K Richardson | Counselor | 3201 Pioneers Blvd, Ste 112, Lincoln, NE 68502-5963 | 2008-09-08 |
| 1629273966 | Leslie Richardson | Chiropractor | 8945 W Post Rd, Suite 105, Las Vegas, NV 89148-2431 | 2007-06-18 |
| 1457488116 | Leslie N. Richardson | Optometrist | 725 Campbellsville Byp, Campbellsville, KY 42718-8846 | 2007-02-28 |
| Street Address |
100 BREWSTER BLVD |
| City | CAMP LEJEUNE |
| State | NC |
| Zip Code | 28547-2575 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588668982 | Pierce Overman | Family Medicine | 100 Brewster Blvd, Naval Hospital, Camp Lejeune, NC 28547-2538 | 2005-06-13 |
| 1275146417 | Kristi Lynn Dixon | Nurse Practitioner | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-08-27 |
| 1841802253 | Konstance Mackie | Nurse Practitioner | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-08-18 |
| 1003425117 | Jeremy Moore | Licensed Practical Nurse | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-07-24 |
| 1801404546 | Erika Merite Papenfuss | Nurse Anesthetist, Certified Registered | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-07-20 |
| 1306454244 | Devon Nicole Dan | Nurse Anesthetist, Certified Registered | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-07-16 |
| 1851918957 | Uriah Nmn Paul | Nurse Anesthetist, Certified Registered | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-07-06 |
| 1447876529 | Leslee Lynne Smith | Speech-Language Pathologist | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-06-24 |
| 1356965727 | Haleigh Leister | Specialist/Technologist | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-06-02 |
| 1407482045 | Shajaylyn Lee-combs | Student in an Organized Health Care Education/Training Program | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-03-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558906032 | Abigail Deemer | Physician Assistant | L Street, Bldg Hp-416, Camp Lejeune, NC 28547 | 2019-11-08 |
| 1407406267 | Michelle Ferricher | Nurse Practitioner | Naval Medical Center Pediatric Clinic, Nh-200 Recovery Way, Camp Lejeune, NC 28547 | 2019-09-13 |
| 1215595566 | Kayla L Torrez Chang | General Practice | Mcmh Fc 308, Hm Smith Boulevard, Camp Lejeune, NC 28547 | 2019-06-02 |
| 1699338442 | Amanda Leigh Jepsen | Military Health Care Provider | Naval Medical Center; 100 Brewster Blvd, Camp Lejeune, NC 28547 | 2019-04-17 |
| 1306336995 | Erik Reid King | Physician Assistant | F Street Bldg. Hp206, Camp Lejeune, NC 28547 | 2018-05-18 |
| 1114434032 | David John Mcdermott | Specialist/Technologist | Bldg. H1 Julian C Smith Rd., Camp Lejuene, NC 28547 | 2017-12-30 |
| 1235678434 | Nicolle Elizabeth Johnson | Occupational Therapist | 180 Hospital Corps Blvd., Camp Lejeune, NC 28547 | 2017-02-21 |
| 1427435585 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | Stone St. Extention, Bldg Nh200, Camp Lejeune, NC 28547 | 2015-04-28 |
| 1043634173 | Garrett Michael Wren | Obstetrics & Gynecology | Naval Medical Center, 100 Brewster Blvd, Camp Lejeune, NC 28547 | 2014-02-10 |
| 1245662436 | Samuel Maluil | Internal Medicine | Bldg 124 Wallace Creek, Camp Lejeunce, NC 28547 | 2013-07-30 |
| Find all providers in zip 28547 | ||||
| Taxonomy Code | 2080P0006X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Developmental – Behavioral Pediatrics |
| A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed, 3/26/2008: definition corrected] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508841743 | Joseph Andersen Mcbreen | Pediatrics | 100 Brewster Blvd, Naval Hospital, Camp Lejeune, NC 28547-2538 | 2005-12-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548746365 | Kassondra Amada Shoemaker Brino | Pediatrics | 307 S Salem St Ste 100, Apex, NC 27502-1845 | 2018-07-15 |
| 1164949814 | Moses Cone Physician Services, Inc. | Pediatrics | 301 E Wendover Ave Ste 311, Greensboro, NC 27401-1210 | 2017-08-24 |
| 1821474628 | Melissa Thingvoll Md Pllc | Pediatrics | 7 Yorkshire St Ste 101, Asheville, NC 28803-2798 | 2015-08-04 |
| 1053445130 | Barbara Nan Samuels | Pediatrics | 108 W Fire Tower Rd Ste B, Ecu Pediatrics Autism Center, Winterville, NC 28590-8408 | 2007-03-14 |
| 1396823498 | Patricia Dockery Weavil | Pediatrics | 4805 Seward Rd, Pfafftown, NC 27040-9450 | 2006-11-02 |
| 1780782805 | Jean Charlotte Smith | Pediatrics | 10 Sunnybrook Road, Wake County Human Services, Raleigh, NC 27610-1808 | 2006-09-20 |
| 1881689362 | Barbara Elizabeth Kissam | Pediatrics | 1900 Randolph Rd, Suite 1010, Charlotte, NC 28207-1122 | 2005-09-12 |
| 1528060209 | Arne John Anderson | Pediatrics | 108 W Fire Tower Rd, Winterville, NC 28590-8371 | 2005-08-12 |
| 1104479708 | Novant Medical Group Inc | Pediatrics | 311 Coddle Market Dr Nw Ste 200, Concord, NC 28027-2432 | 2019-07-23 |
| 1508426370 | Novant Medical Group Inc | Pediatrics | 17810 Statesville Rd Ste 311, Cornelius, NC 28031-8149 | 2019-06-14 |
| Find all providers with the same taxonomy | ||||
| City | CAMP LEJEUNE |
| Zip Code | 28547 |
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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.