Active NPI
Leah Mira Blum, APRN-CNP
- Nurse Practitioner
- Charlotte, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 5017837
- Practice address
- 1918 Randolph Rd Ste 220
Charlotte, NC 28207-1109 - Phone
- (704) 316-1125
- Fax
- (704) 316-1143
- NPI assigned
- Jun 15, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 0028739 | OH | |
| Nurse Practitioner | 363L00000X | 5017837 | NC | Primary |
| Gerontology Nurse Practitioner | 363LG0600X | 0028739 | OH | |
| Primary Care Nurse Practitioner | 363LP2300X | 0028739 | OH | |
| Nurse Practitioner | 363L00000X | 0028739 | OH |
Addresses
Primary practice location
1918 Randolph Rd Ste 220
Charlotte, NC 28207-1109
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-1125
Other practice location 1
9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-2200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1918 Randolph Rd
Suite 220
Charlotte, NC 28207-1109
Phone (704) 316-1125
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0028739 | OH | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novant Health Medical Group. LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Past | Accepting new patients |
Locations
1918 Randolph Rd
Ste 220
Charlotte, NC 28207
Phone (704) 316-1125
5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441
2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300
Interoperability endpoints
- lblum1124409@direct.novanthealth.org
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.
-
- Neurology with Special Qualifications in Child Neurology Physician
- Charlotte, NC
- NPI 1366409492
-
- Endocrinology, Diabetes & Metabolism Physician
- Charlotte, NC
- NPI 1306950282
-
- Obstetrics & Gynecology Physician
- Matthews, NC
- NPI 1386506137
-
- Pediatrics Physician
- Charlotte, NC
- NPI 1023727542
-
- Internal Medicine Physician
- Charlotte, NC
- NPI 1134841802
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681257600000",
"number": "1023686185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60447",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282600447",
"telephone_number": "704-316-1125",
"fax_number": "704-316-1143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1918 RANDOLPH RD STE 220",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282071109",
"telephone_number": "704-316-1125",
"fax_number": "704-316-1143"
}
],
"practiceLocations": [
{
"address_1": "9500 Euclid Ave",
"address_purpose": "LOCATION",
"city": "Cleveland",
"state": "OH",
"postal_code": "441950001",
"country_code": "US",
"telephone_number": "216-444-2200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BLUM",
"first_name": "LEAH",
"middle_name": "MIRA",
"credential": "APRN-CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-15",
"last_updated": "2023-04-12",
"certification_date": "2023-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "OH",
"license": "0028739",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "5017837",
"primary": true
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "OH",
"license": "0028739",
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "OH",
"license": "0028739",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OH",
"license": "0028739",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.