Individual provider Active NPI

Leilani Hope Victor, PA

  • Physician Assistant
  • White House, TN
National Provider Identifier
1013600253
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6255 Issued in TN
Practice address
607 Highway 76
White House, TN 37188-9206
Phone
(615) 616-9415
NPI assigned
Jun 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6255 TN Primary

Addresses

Primary practice location

607 Highway 76
White House, TN 37188-9206

Mailing address

333 Murfreesboro Pike
Nashville, TN 37210-2834
Phone (615) 248-1225

Other practice location 1

333 Murfreesboro Pike
Nashville, TN 37210-2834
Phone (615) 248-1225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20250224000215 TN Practitioner - Physician Assistant 9436679354 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians

Practice addresses (Care Compare)

100 E Tennessee St
Collinwood, TN 38450
Phone (931) 724-9000

2372 Lebanon Pike
Nashville, TN 37214-2411
Phone (629) 206-0541

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6255TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Jan 16, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Jan 16, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Trevecca Nazarene University PastSince Jun 1, 2023 Accepting new patients

Locations

7348 E Brainerd Rd
Chattanooga, TN 37421
Phone (205) 822-8038

718 E College St
Dickson, TN 37055
Phone (615) 560-7016

1128 N Castle Heights Ave
Lebanon, TN 37087
Phone (423) 352-4381

1307 N Ellington Pkwy
Lewisburg, TN 37091
Phone (931) 359-4555

235 Highway 52 W
Portland, TN 37148
Phone (615) 802-1087

1420 W College St
Pulaski, TN 38478
Phone (931) 363-3004

3813 Old Port Royal Rd N
Spring Hill, TN 37174
Phone (931) 487-1006

607 Highway 76
White House, TN 37188
Phone (615) 616-9415

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CDJEAA/Endpoint/CDJEAA

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1685577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1013600253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 MURFREESBORO PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372102834",
            "telephone_number": "615-248-1225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 HIGHWAY 76",
            "city": "WHITE HOUSE",
            "state": "TN",
            "postal_code": "371889206",
            "telephone_number": "615-616-9415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 Murfreesboro Pike",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372102834",
            "country_code": "US",
            "telephone_number": "615-248-1225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VICTOR",
        "first_name": "LEILANI",
        "middle_name": "HOPE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-01",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "6255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White House, TN

Sources for this page

Verify at the official NPI Registry.