Individual provider Active NPI

Leslie Herman Myers, D.O.

  • Family Medicine Physician
  • Jacksonville, NC
National Provider Identifier
1063891034
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
219732 Issued in NC
Practice address
245 Memorial Dr
Jacksonville, NC 28546-6333
Phone
(910) 353-4333
Fax
(910) 353-2108
NPI assigned
May 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 219732 NC Primary

Addresses

Primary practice location

245 Memorial Dr
Jacksonville, NC 28546-6333

Mailing address

245 Memorial Dr
Jacksonville, NC 28546-6333
Phone (910) 353-4333

Other practice location 1

100 Brewster Blvd
Camp Lejeune, NC 28547-2538
Phone (910) 450-3138

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241009000241 NC Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 8820420789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Womens Healthcare Associates PAGroup PAC ID 6305019555, 6 clinicians

Practice addresses (Care Compare)

245 Memorial Dr
Jacksonville, NC 28546-6333
Phone (910) 353-4333

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
219732NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Womens Healthcare Associates PA CurrentSince Aug 6, 2024 Accepting new patients

Locations

245 Memorial Dr
Jacksonville, NC 28546
Phone (910) 353-4333

Organizations & group practices 1

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.

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": "1432339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1063891034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 MEMORIAL DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466333",
            "telephone_number": "910-353-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 MEMORIAL DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466333",
            "telephone_number": "910-353-4333",
            "fax_number": "910-353-2108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Brewster Blvd",
            "address_purpose": "LOCATION",
            "city": "Camp Lejeune",
            "state": "NC",
            "postal_code": "285472538",
            "country_code": "US",
            "telephone_number": "910-450-3138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYERS",
        "first_name": "LESLIE",
        "middle_name": "HERMAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-23",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "219732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.