Active NPI
Leslie Gallagher, NP
- Nurse Practitioner
- Wilmington, NC
National Provider Identifier
1063435683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 600013
- Practice address
- 311-4E Judges Road
Wilmington, NC 28405-3655 - Phone
- (415) 899-9800
- Fax
- (415) 899-9805
- NPI assigned
- Jul 25, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 11529 | CA | |
| Psychiatry Physician | 2084P0800X | 600013 | NC | |
| Nurse Practitioner | 363L00000X | 600013 | NC | Primary |
Addresses
Primary practice location
311-4E Judges Road
Wilmington, NC 28405-3655
Mailing address
P.O. Box 696
Hampstead, NC 28443-0696
Phone (910) 791-6767
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7000774 | Medicaid | NC | |
| NP0115290 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11529 | CA | MD | Mental Health Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Act Medical Group PA | Past | Accepting new patients | |
| Gerihealthsolutions, Inc. | Gerontology | Past | Accepting new patients |
| Act Medical Group, PA | Past | Accepting new patients | |
| Priest NP Services | Gerontology | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Specialist
- Wilmington, NC
- NPI 1245219799
-
- Family Medicine Physician
- Wilmington, NC
- NPI 1598982860
-
dba geriHEALTHcare
- Gerontology Nurse Practitioner
- Novato, CA
- NPI 1275699704
-
- Gerontology Nurse Practitioner
- Novato, CA
- NPI 1306905336
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301356800000",
"number": "1063435683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 696",
"city": "HAMPSTEAD",
"state": "NC",
"postal_code": "284430696",
"telephone_number": "910-791-6767",
"fax_number": "910-791-6890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311-4E JUDGES ROAD",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284053655",
"telephone_number": "415-899-9800",
"fax_number": "415-899-9805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLAGHER",
"first_name": "LESLIE",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-25",
"last_updated": "2011-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "CA",
"license": "11529",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NC",
"license": "600013",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "600013",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7000774",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NP0115290",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.