Active NPI
Leah Christine Fitzgerald, FNP-BC
- Family Nurse Practitioner
- Jacksonville, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 5015134
- Practice address
- 114A Memorial Dr
Jacksonville, NC 28546-6328 - Phone
- (910) 353-0700
- Fax
- (910) 353-5305
- NPI assigned
- Aug 28, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | FITZ-17X2Y | NC | |
| Family Nurse Practitioner | 363LF0000X | 5015134 | NC | Primary |
Addresses
Primary practice location
114A Memorial Dr
Jacksonville, NC 28546-6328
Mailing address
PO Box 986513
Boston, MA 02298-6513
Phone (910) 219-8326
Other practice location 1
Clinic #5313
13304 Leesville Church Road
Raleigh, NC 28617
Phone (919) 845-5276
Other practice location 2
1106 Main Street Ext
Swansboro, NC 28584-9114
Phone (910) 325-0581
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5015134 | NC | MD | Family Nurse Practitioner |
| FITZ-17X2Y | NC | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jacksonville Children'S and Multispecialty Clinic, PA | Multi-Specialty | Current | Accepting new patients |
| Amm Healthcare, PA | Multi-Specialty | Current | Accepting new patients |
| Family Care Clinic, P.a. | Multi-Specialty | Past | Accepting new patients |
Locations
114C Memorial Dr
Jacksonville, NC 28546
Phone (910) 346-3976
114A Memorial Dr
Jacksonville, NC 28546
Phone (910) 353-0700
120 Memorial Dr
Jacksonville, NC 28546
Phone (910) 353-0581
1106 Main Street Ext
Swansboro, NC 28584
Phone (910) 325-0581
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
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.
-
- Family Medicine Physician
- Jacksonville, NC
- NPI 1164519070
Multi-Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698969600000",
"number": "1043987852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 986513",
"city": "BOSTON",
"state": "MA",
"postal_code": "022986513",
"telephone_number": "910-219-8326",
"fax_number": "910-939-4269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114A MEMORIAL DR",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285466328",
"telephone_number": "910-353-0700",
"fax_number": "910-353-5305"
}
],
"practiceLocations": [
{
"address_1": "Clinic #5313",
"address_2": "13304 Leesville Church Road",
"address_purpose": "LOCATION",
"city": "Raleigh",
"state": "NC",
"postal_code": "28617",
"country_code": "US",
"telephone_number": "919-845-5276",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1106 Main Street Ext",
"address_purpose": "LOCATION",
"city": "Swansboro",
"state": "NC",
"postal_code": "285849114",
"country_code": "US",
"telephone_number": "910-325-0581",
"fax_number": "910-325-0582",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FITZGERALD",
"first_name": "LEAH",
"middle_name": "CHRISTINE",
"credential": "FNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-28",
"last_updated": "2023-11-03",
"certification_date": "2023-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "NC",
"license": "FITZ-17X2Y",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "NC",
"license": "5015134",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.