Leisha Monette Blaylock (NPI# 1083018063, PAC ID# 5294058855) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1083018063 |
| PAC ID by PECOS | 5294058855 |
| Professional Enrollment ID | I20150106002567 |
| Full Name | Leisha Monette Blaylock |
| Organization Legal Name | WISE CLINICAL CARE ASSOCIATES |
| Address |
2202 Us Hwy 380 Suite 111 Bridgeport TX 76426-2177 |
| Phone Number | 9406833017 |
| Gender | F |
| Graduation Year | 2014 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 6204988975 |
| Number of Group Practice Members | 36 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 450271 | WISE REGIONAL HEALTH SYSTEM |
| Address | Phone | Organization |
|---|---|---|
| 2202 Us Hwy 380, Suite 111, Bridgeport, TX 76426-2177 | 9406833017 | WISE CLINICAL CARE ASSOCIATES |
| Organization Legal Name | WISE CLINICAL CARE ASSOCIATES |
| Physicians | 42 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher Barret Moeder | General Surgery | Wise Clinical Care Associates | 2000 Ben Merritt Dr, Unit B, Decatur, TX 76234-3848 |
| Ryan Andrew Matthiesen | Family Medicine | Wise Clinical Care Associates | 2432 Avondale Haslet Rd, Suite 200, Haslet, TX 76052-3428 |
| Henock Zabher | Cardiovascular Disease (cardiology) | Wise Clinical Care Associates | 2301 S Fm, 51 Suite 100, Decatur, TX 76234-3864 |
| Lauren Hailey Morton | Nurse Practitioner | Wise Clinical Care Associates | 133 N Fm, 730 Unit 105, Boyd, TX 76023-3072 |
| Cynthia Lynn Hartman | Obstetrics/gynecology | Wise Clinical Care Associates | 2451 S Fm, 51 Suite 200, Decatur, TX 76234-3860 |
| Robert Kendall Clifford Jr. | Orthopedic Surgery | Wise Clinical Care Associates | 1851 Medical Ctr Dr, Decatur, TX 76234-3852 |
| Beryl A Brigham | Nurse Practitioner | Wise Clinical Care Associates | 2014 Ben Merritt Dr, Suite A, Decatur, TX 76234-3851 |
| Neelima U Maddukuri | Hematology/oncology | Wise Clinical Care Associates | 2010 Ben Merritt Dr, Unit A, Decatur, TX 76234-3853 |
| Michael David Shaffer | Family Medicine | Wise Clinical Care Associates | 3124 N Tarrant Pkwy, 200 Fit N Wise Rehab Clinic Alliance, Fort Worth, TX 76177-8618 |
| Jana Marie Brady | Nurse Practitioner | Wise Clinical Care Associates | 133 N Fm, 730 Unit 105, Boyd, TX 76023-3072 |
| Street Address |
2202 US HWY 380 SUITE 111 |
| City | BRIDGEPORT |
| State | TX |
| Zip | 76426-2177 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sharon Gay Mclemore | Nurse Practitioner | Wise Clinical Care Associates | 2202 Us Hwy 380, Suite 112, Bridgeport, TX 76426-2177 |
| Jon Wesley Walker | Family Practice | Wise Clinical Care Associates | 2202 Us Hwy 380, Bridgeport, TX 76426-2177 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Wade Holloway | Physician Assistant | David A Ray Do Pa | 808 Woodrow Wilson Ray Cir, Bridgeport, TX 76426-2061 |
| Santa Espinoza | Nurse Practitioner | David A Ray Do Pa | 808 Woodrow Wilson Ray Circle, Bridgeport, TX 76426-2061 |
| Jennifer R Mullican | Physician Assistant | David A Ray Do Pa | 808 Woodrow Wilson Ray Circle, Bridgeport, TX 76426-2061 |
| Michael A Millis | Physician Assistant | David A Ray Do Pa | 808 Woodrow Wilson Ray Circle, Bridgeport, TX 76426-2061 |
| David A Ray | Family Medicine | David A Ray Do Pa | 808 Woodrow Wilson Ray Circle, Bridgeport, TX 76426-2061 |
| Andrea Megan Deloera | Physician Assistant | Denise M. Casper, D.o, P.a. | 808 Woodrow Wilson Ray Circle, Bridgeport, TX 76426-2061 |
| Patricia R Young | Optometry | 807 Woodrow Wilson Ray Cir, Bridgeport, TX 76426-2062 | |
| Jenna M Chapa | Nurse Practitioner | Decatur Hospital Authority | 1905 Doctors Hospital Dr, Bridgeport, TX 76426-2260 |
| Scott Stowers | General Surgery | 1903 Doctors Hospital Dr, Suite 34, Bridgeport, TX 76426-2277 | |
| Ja'near Anderson | Pediatric Medicine | Wise Clinical Care Associates | 1903 Doctors Hospital Dr, Bridgeport, TX 76426-2277 |
| Find all physicians in zip 76426 | |||
| City | BRIDGEPORT |
| Zip Code | 76426 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | BRIDGEPORT + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Leisha Monette Blaylock.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.