Individual provider Active NPI

Leah Wong, FNP-C

  • Family Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1043796303
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28179480A Issued in IN
Practice address
201 North Illinois Street
16TH Floor South Tower
Indianapolis, IN 46204
Phone
(888) 731-8994
Fax
(833) 775-1861
NPI assigned
Jul 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28179480A IN Primary

Addresses

Primary practice location

201 North Illinois Street
16TH Floor South Tower
Indianapolis, IN 46204

Mailing address

201 North Illinois St.
16TH Floor South Tower
Indianapolis, IN 46204

Other practice location 1

139 Centre St Ph 120
New York, NY 10013-4559
Phone (888) 731-8994

Other practice location 2

195 Page Mill Rd Ste 103
Palo Alto, CA 94306-2073
Phone (888) 731-8994

Other practice location 3

4254 W Orchid Ln
Chandler, AZ 85226-7246
Phone (888) 731-8994

Other practice location 4

112 Maverick Ct
Granbury, TX 76049-1381
Phone (888) 731-8994

Other practice location 5

111 N Orange Ave Ste 800
Orlando, FL 32801-2381
Phone (888) 731-8994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28179480AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Her Vital Wellness, LLC Family Current Accepting new patients
Oak Street Health Physicians Group, PC Family Past Accepting new patients
Integrative Womens Care PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: leah.wong.1@27069.direct.athenahealth.com

Organizations & group practices 3

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": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1043796303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 NORTH ILLINOIS ST.",
            "address_2": "16TH FLOOR SOUTH TOWER",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 NORTH ILLINOIS STREET",
            "address_2": "16TH FLOOR SOUTH TOWER",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46204",
            "telephone_number": "888-731-8994",
            "fax_number": "833-775-1861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "139 Centre St Ph 120",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100134559",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "195 Page Mill Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943062073",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4254 W Orchid Ln",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852267246",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "112 Maverick Ct",
            "address_purpose": "LOCATION",
            "city": "Granbury",
            "state": "TX",
            "postal_code": "760491381",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 N Orange Ave Ste 800",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328012381",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "LEAH",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-18",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28179480A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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.