Mary K Leavery, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

45453 Issued in NC

Practice address

145 Kimel Park Dr Ste 120
Winston Salem, NC 27103

Phone

(336) 768-3212

Fax

(336) 768-9019

NPI assigned

Aug 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

State University of New York at Buffalo School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Park Hospital LLCGroup PAC ID 4880595958, 109 clinicians

Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Medical Park Hospital Hospital, Winston-Salem, NC, CCN 340148
• Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mleavery432660@direct.novanthealth.org

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.

• Forsyth Memorial Hospital, Inc.

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1104548874
  Medicare reassignment Care Compare group NPD
• Medical Park Hospital LLC

  • Specialist
  • Winston-Salem, NC
  • NPI 1003867516
  Medicare reassignment Care Compare group NPD
• Brunswick Community Hospital, LLC

  • Certified Registered Nurse Anesthetist
  • Bolivia, NC
  • NPI 1669725198

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Novant Health Clemmons Outpatient Surgery, LLC

  • Ambulatory Surgical Clinic/Center
  • Clemmons, NC
  • NPI 1528521887
  Medicare reassignment NPD
• Novant Health Kernersville Outpatient Surgery LLC

  • Ambulatory Surgical Clinic/Center
  • Kernersville, NC
  • NPI 1750892659
  Medicare reassignment NPD
• Novant Health Matthews Medical Center LLC

  • Specialist
  • Matthews, NC
  • NPI 1184782419
  Medicare reassignment NPD
• Novant Health Mint Hill Medical Center, LLC

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
  • NPI 1063910404

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Novant Health Rowan Medical Center LLC

  • Neurology Physician
  • Salisbury, NC
  • NPI 1508931544

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Novant Health Thomasville Medical Center, LLC

  • Specialist
  • Thomasville, NC
  • NPI 1033160205

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Piedmont Triad Anesthesia, PA

  • Anesthesiology Physician
  • Winston-Salem, NC
  • NPI 1467497081

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Presbyterian Sameday Surgery Center at Ballantyne LLC

  • Ambulatory Surgical Clinic/Center
  • Charlotte, NC
  • NPI 1215061049
  Medicare reassignment NPD
• Presbyterian Sameday Surgery Center at Huntersville LLC

  • Ambulatory Surgical Clinic/Center
  • Huntersville, NC
  • NPI 1063641801
  Medicare reassignment NPD

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

• Forsyth Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1447200233
  Care Compare affiliation
• Medical Park Hospital LLC

  • General Acute Care Hospital
  • Winston-Salem, NC
  • NPI 1538111828
  Care Compare affiliation

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1063520005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 KIMEL PARK DR STE 120",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036983",
            "telephone_number": "336-768-3212",
            "fax_number": "336-768-9019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 KIMEL PARK DR STE 120",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27103",
            "telephone_number": "336-768-3212",
            "fax_number": "336-768-9019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "830 Washington St",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "NY",
            "postal_code": "136014034",
            "country_code": "US",
            "telephone_number": "315-785-4313",
            "fax_number": "315-779-5114",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "830 Washington St",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "NY",
            "postal_code": "136014034",
            "country_code": "US",
            "telephone_number": "315-785-4313",
            "fax_number": "315-779-5114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEAVERY",
        "first_name": "MARY",
        "middle_name": "K",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "993",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "45453",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "360053-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN0749",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MLEAVERY432660@DIRECT.NOVANTHEALTH.ORG",
            "affiliation": "N",
            "address_1": "830 Washington St",
            "city": "Watertown",
            "state": "NY",
            "country_code": "US",
            "postal_code": "136014034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joshua Perez Leano
• Charlotte Palmer Leape, MD
• Learn & Blossom ABA Therapy
• Samantha Diane Leary, LCAS
• Camille Ann Leaver, M.A.
• Kathleen Anne Leavitt, M.D.
• Douglas Leclair, CO
• James Weil Lederer Jr., M.D.
• Lee Physician Consulting PLLC
• Allison Lee-Shaner, LMFT

• Certified Registered Nurse Anesthetist in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Certified Registered Nurse Anesthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.