NPIMap

Individual provider Active NPI

Leah Hermanson, NP-C

  • Nurse Practitioner
  • Sedalia, MO
National Provider Identifier
1063959518
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F0117368 Issued in MO
Practice address
1718 S Ingram Ave
Suite C
Sedalia, MO 65301-7505
Phone
(660) 827-2535
NPI assigned
Jan 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F0117368 MO Primary

Addresses

Primary practice location

1718 S Ingram Ave
Suite C
Sedalia, MO 65301-7505

Mailing address

601 E 14TH St
Sedalia, MO 65301-5972

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170317000088 MO Practitioner - Nurse Practitioner 8921383704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bothwell Regional Health CenterGroup PAC ID 6103714126, 109 clinicians

Practice addresses (Care Compare)

2301 S Ingram Ave
Bothwell Internal Medicine Special
Sedalia, MO 65301-8121
Phone (660) 827-2526

Hospital & facility affiliations

  • Johnson County Community Health Services Home health agency, Warrensburg, MO, CCN 267058
  • Bothwell Regional Health Center Hospital, Sedalia, MO, CCN 260009
  • Fitzgibbon Hospital Hospital, Marshall, MO, CCN 260142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F0117368MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bothwell Regional Health Center CurrentSince Mar 15, 2017 Accepting new patients
Bothwell Regional Health Center CurrentSince Mar 15, 2017 Accepting new patients
Bothwell Regional Health Center Current Accepting new patients
Sylvia G. Thompson Residence Center Past Accepting new patients
Kenneth N. Azan, M.D., PC Past Accepting new patients

Locations

601 E 14th St
Sedalia, MO 65301
Phone (660) 826-8833

1718 S Ingram Ave
Ste C
Sedalia, MO 65301
Phone (660) 827-1594

2301 S Ingram Ave
Sedalia, MO 65301
Phone (660) 826-5890

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 and National Provider Directory roles.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1063959518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E 14TH ST",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653015972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 S INGRAM AVE",
            "address_2": "SUITE C",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653017505",
            "telephone_number": "660-827-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMANSON",
        "first_name": "LEAH",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-23",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "F0117368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sedalia, MO

Sources for this page

Verify at the official NPI Registry.