Leroy Bibbs Jr., MASTER'S DEGREE HUMA

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

27-0843094 Issued in PA

Practice address

203 Long Ridge Dr
Columbia, SC 29229-9284

Phone

(215) 266-8158

NPI assigned

Apr 2, 2021

Last updated

Apr 2, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1093393621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 LONG RIDGE DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292299284",
            "telephone_number": "215-266-8158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 LONG RIDGE DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292299284",
            "telephone_number": "215-266-8158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIBBS",
        "first_name": "LEROY",
        "name_suffix": "Jr.",
        "credential": "MASTER'S DEGREE HUMA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-02",
        "last_updated": "2021-04-02",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "PA",
            "license": "27-0843094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "leroy.bibbs@uhsinc.com",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "messaging",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "messaging",
            "address_1": "203 Long Ridge Dr",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292299284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mohamed Shabir Bharadia, OD
• Rupa Bhasin, M.D.
• Kuldeep Bhatt, APRN
• Madeline Bhend, MD
• Michelle Biashvili, RN
• Katrina Alexandria Bidwell, M.D.
• Julia Rose Biernat, MSP, CCC-SLP
• Big Brothers Big Sisters of GR. Columbia
• Big Dawg Community Solutions
• Abigail Rose Bigelow, PHD

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Columbia, SC
• Providers in Columbia, SC by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.