Individual provider Active NPI

Leah Jones Calder, PA-C

  • Physician Assistant
  • Vicksburg, MS
National Provider Identifier
1063479608
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00133 Issued in MS
Practice address
188 YMCA PL
Vicksburg, MS 39183-3536
Phone
(601) 630-3376
NPI assigned
Apr 27, 2006
Last updated
Jun 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 004472 GA
Physician Assistant 363A00000X PA00133 MS Primary

Addresses

Primary practice location

188 YMCA PL
Vicksburg, MS 39183-3536

Mailing address

204 Brenhaven Blvd
Brandon, MS 39047-6172
Phone (404) 790-8019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101124000373 MS Practitioner - Physician Assistant 1759327166 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Dermatology Clinic, PLLCGroup PAC ID 8123129673, 8 clinicians

Practice addresses (Care Compare)

11295 E Taylor Rd
Gulfport, MS 39503-4197
Phone (228) 864-3300

188 YMCA PL
Vicksburg, MS 39183-3536
Phone (601) 540-4025

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
004472GAMDPhysician Assistant
PA00133MSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Madison Medical Rheumatology, LLC PastSince Jul 1, 2014 Accepting new patients
Skin in the Game, PLLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lcalder@directaddress.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1063479608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 BRENHAVEN BLVD",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390476172",
            "telephone_number": "404-790-8019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 YMCA PL",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391833536",
            "telephone_number": "601-630-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDER",
        "first_name": "LEAH",
        "middle_name": "JONES",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "004472",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MS",
            "license": "PA00133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

Verify at the official NPI Registry.