Wendy Ledesma, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

6387 Issued in GA

Practice address

3772 Satellite Blvd Ste 204
Duluth, GA 30096-5681

Phone

(470) 885-8080

Fax

(470) 885-8088

NPI assigned

May 8, 2007

Last updated

Dec 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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

• Grace Medical and Wellness Center, LLC

  • Family Medicine Physician
  • Duluth, GA
  • NPI 1720698426
  NPD

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1043423510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3772 SATELLITE BLVD STE 204",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965681",
            "telephone_number": "470-885-8080",
            "fax_number": "470-885-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3772 SATELLITE BLVD STE 204",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965681",
            "telephone_number": "470-885-8080",
            "fax_number": "470-885-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDESMA",
        "first_name": "WENDY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "6387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@mygracemedical.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3772 Satellite Blvd Ste 204",
            "city": "Duluth",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300965681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lca-Vision Inc
• Anhthu Pham Le, PHARMD
• Lam Le
• Calesa Nicole Leach, MS, CCC-SLP
• Jennifer Lech, M.P.T.
• Lee Home Care LLC
• Lee Physical Therapy and Rehab Inc
• Abraham Lee, MD
• Beom J Lee, D.D.S.
• Brandon Yongjo Lee, L.AC.

• Medical Physician Assistant in Duluth, GA
• Providers in Duluth, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.