Leah Ann Disque Supalla, APN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

0000014965 Issued in TN

Practice address

3601 The Vanderbilt Clinic
Nashville, TN 37232-0001

Phone

(615) 936-2000

NPI assigned

Jul 9, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Vanderbilt University Medical Center

  dba Vanderbilt Medical Group

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1104202761
  Medicare reassignment NPD
• Vanderbilt University

  dba Vanderbilt Medical Group

  • Clinical Social Worker
  • Nashville, TN
  • NPI 1285659706
  NPD (past)

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1063724755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 THOMPSON LN STE 30330",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372044701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 THE VANDERBILT CLINIC",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372320001",
            "telephone_number": "615-936-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Division Of Critical Care Medicine",
            "address_2": "Doctor's Office Tower Suite 5121 2200 Children's Way",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372320001",
            "country_code": "US",
            "telephone_number": "615-936-3968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUPALLA",
        "first_name": "LEAH",
        "middle_name": "ANN DISQUE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-09",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "0000014965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lsupalla21723@direct.vumc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "Division Of Critical Care Medicine",
            "address_2": "Doctor's Office Tower Suite 5121 2200 Children's Way",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashley Renee Sunkel
• Sunrise ABA of Tennessee LLC
• Sunrise Anesthesia LLC
• Kathryn Ivy Sunthankar, MD
• Sudeep Sunthankar, M.D.
• Superior O & P, LLC
• Superior Orthotics & Prosthetics, LLC
• Kiabe S Supuwood-Allen, M.D.
• Jaimin Surati, DMD
• James Lyman Surface

• Pediatric Nurse Practitioner in Nashville, TN
• Providers in Nashville, TN by specialty
• Pediatric Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.

Verify at the official NPI Registry.