Individual provider Active NPI

Leeanna Beasley Lee, PA

  • Physician Assistant
  • Dunn, NC
National Provider Identifier
1083375778
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1480 Maple Grove Church Rd
Dunn, NC 28334-7692
Phone
(910) 567-6194
NPI assigned
Jan 4, 2022
Last updated
Nov 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1480 Maple Grove Church Rd
Dunn, NC 28334-7692

Mailing address

1480 Maple Grove Church Rd
Dunn, NC 28334-7692
Phone (910) 567-6194

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221114000207 NC Practitioner - Physician Assistant 0143697680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Campbell Univ School of Osteopathic Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1470 Maple Grove Church Rd
Dunn, NC 28334-7692
Phone (910) 567-7155

1480 Maple Grove Church Rd
Dunn, NC 28334-7692
Phone (910) 567-6194

3331 Easy St
Dunn, NC 28334-7988
Phone (910) 567-6194

500 S Fayetteville St
Salemburg, NC 28385-8406
Phone (910) 525-5515

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tri County Community Health Council Inc CurrentSince Oct 13, 2022 Accepting new patients
Tri County Community Health Council Inc CurrentSince Oct 13, 2022 Accepting new patients

Locations

1480 Maple Grove Church Rd
Dunn, NC 28334
Phone (910) 567-5020

3331 Easy St
Dunn, NC 28334

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1641254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1083375778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 MAPLE GROVE CHURCH RD",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283347692",
            "telephone_number": "910-567-6194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 MAPLE GROVE CHURCH RD",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283347692",
            "telephone_number": "910-567-6194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "LEEANNA",
        "middle_name": "BEASLEY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-04",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunn, NC

Sources for this page

Verify at the official NPI Registry.