NPIMap

Individual provider Active NPI

Michelle Jo Leathers, M.D.

  • Family Medicine Physician
  • Lebanon, KY
National Provider Identifier
1093797185
Registry record updated Feb 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37700 Issued in KY
Practice address
325 W Walnut St
Lebanon, KY 40033-1377
Phone
(270) 699-9500
Fax
(270) 699-9550
NPI assigned
Nov 15, 2005
Last updated
Feb 16, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 37700 KY Primary

Addresses

Primary practice location

325 W Walnut St
Lebanon, KY 40033-1377

Mailing address

325 W Walnut St
Lebanon, KY 40033-1377
Phone (270) 699-9126

Other identifiers 1

IdentifierTypeStateIssuer
64064041MedicaidKY

Other names 1

  • Mrs. Michelle Jo Bowman Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20040824000335 KY Practitioner - Family Practice 7517931728 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Louisville School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family and Internal Medicine Associates PLLCGroup PAC ID 9335051002, 12 clinicians

Practice addresses (Care Compare)

325 W Walnut
Suite 600
Lebanon, KY 40033-1378

325 W Walnut St
Lebanon, KY 40033-1378
Phone (270) 699-9500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37700KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
VMD Primary Providers Central Kentucky Family Medicine CurrentSince Jan 17, 2023 Accepting new patients
Primary Care Medical Center Inc Family Medicine Current Accepting new patients
Family & Internal Medicine Associates PLLC Family Medicine CurrentSince Aug 1, 2003 Accepting new patients
VMD Primary Providers Central Kentucky Family Medicine CurrentSince Jan 17, 2023 Accepting new patients

Locations

325 W Walnut St
Lebanon, KY 40033
Phone (270) 699-9500

325 W Walnut St
Ste 600
Lebanon, KY 40033
Phone (270) 699-9500

1000 S 12th St
Murray, KY 42071
Phone (270) 759-9200

102 W Depot St
Springfield, KY 40069
Phone (606) 336-7343

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22417/brand/1/csg/1/fhir/r4
  • Direct secure messaging: michelle.leathers.1@22064.direct.athenahealth.com

Organizations & group practices 4

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 4

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266278400000",
    "number": "1093797185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W WALNUT ST",
            "city": "LEBANON",
            "state": "KY",
            "postal_code": "400331377",
            "telephone_number": "270-699-9126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W WALNUT ST",
            "city": "LEBANON",
            "state": "KY",
            "postal_code": "400331377",
            "telephone_number": "270-699-9500",
            "fax_number": "270-699-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEATHERS",
        "first_name": "MICHELLE",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2010-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "37700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64064041",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "BOWMAN",
            "middle_name": "JO",
            "prefix": "MRS.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lebanon, KY

Sources for this page

Verify at the official NPI Registry.