Individual provider Active NPI

Alexandra B Leis, NP-C

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1083099741
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3009450 Issued in KY
Practice address
310 E Broadway Ste 200
Louisville, KY 40202-1745
Phone
(502) 585-5249
Fax
(502) 585-5251
NPI assigned
Jul 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3009450 KY Primary

Addresses

Primary practice location

310 E Broadway Ste 200
Louisville, KY 40202-1745

Mailing address

310 E Broadway Ste 200
Louisville, KY 40202-1745
Phone (502) 585-5249

Other identifiers 1

IdentifierTypeStateIssuer
7100370810MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20150826000315 KY Practitioner - Nurse Practitioner 4385950088 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Louisville School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr William M Parsley MD PSCGroup PAC ID 1951378850, 6 clinicians
Vitalskin Medical Group Il PLLCGroup PAC ID 5991116261, 56 clinicians

Practice addresses (Care Compare)

10619 Meeting St
Suite 106
Prospect, KY 40059-6555
Phone (502) 326-2622

114 Manor Ave
Bardstown, KY 40004-3230
Phone (217) 729-7868

310 E Broadway
Suite 200
Louisville, KY 40202-1745
Phone (502) 585-5249

Hospital & facility affiliations

  • Baptist Health Lagrange Hospital, La Grange, KY, CCN 180138

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3009450KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dr William M Parsley MD PSC CurrentSince Jun 1, 2017 Accepting new patients
Vitalskin Medical Group Il PLLC CurrentSince Oct 2, 2023 Accepting new patients
Vitalskin Medical Group Il PLLC CurrentSince Oct 2, 2023 Accepting new patients

Locations

114 Manor Ave
Bardstown, KY 40004
Phone (217) 729-7868

5129 Dixie Hwy
Ste 301
Louisville, KY 40216
Phone (502) 449-0449

310 E Broadway
Ste 200
Louisville, KY 40202
Phone (502) 585-5249

10619 Meeting St
Unit 106
Prospect, KY 40059
Phone (502) 326-2622

Organizations & group practices 3

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": "1437609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1083099741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E BROADWAY STE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021745",
            "telephone_number": "502-585-5249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E BROADWAY STE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021745",
            "telephone_number": "502-585-5249",
            "fax_number": "502-585-5251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIS",
        "first_name": "ALEXANDRA",
        "middle_name": "B",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3009450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100370810",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.