Active NPI
Mayri Sagady Leslie, CNM
- Advanced Practice Midwife
- New Haven, CT
National Provider Identifier
1104071265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- 336
- Practice address
- 100 Church St S
New Haven, CT 06519-1703 - Phone
- (619) 743-4989
- Fax
- (203) 737-2597
- NPI assigned
- Nov 17, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 0001206629 | VA | |
| Registered Nurse | 163W00000X | 504434 | CA | |
| Advanced Practice Midwife | 367A00000X | 0024167388 | VA | |
| Advanced Practice Midwife | 367A00000X | RN1011287 | DC | |
| Advanced Practice Midwife | 367A00000X | 1274 | CA | |
| Advanced Practice Midwife | 367A00000X | 336 | CT | Primary |
| Advanced Practice Midwife | 367A00000X | AC00567 | MD | |
| Registered Nurse | 163W00000X | 89442 | CT |
Addresses
Primary practice location
100 Church St S
New Haven, CT 06519-1703
Mailing address
100 Church St S
New Haven, CT 06519-1703
Phone (619) 743-4989
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 336 | CT | MD | Behavioral Analyst |
| 504434 | CA | MD | Registered Nurse |
| 89442 | CT | MD | Registered Nurse |
| 0001206629 | VA | MD | Registered Nurse |
| 1274 | CA | MD | Speech-Language Assistant |
| RN1011287 | DC | MD | Advanced Practice Midwife |
| AC00567 | MD | MD | Advanced Practice Midwife |
| 0024167388 | VA | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267920000000",
"number": "1104071265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 CHURCH ST S",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065191703",
"telephone_number": "619-743-4989",
"fax_number": "203-737-2597"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 CHURCH ST S",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065191703",
"telephone_number": "619-743-4989",
"fax_number": "203-737-2597"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LESLIE",
"first_name": "MAYRI",
"middle_name": "SAGADY",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-17",
"last_updated": "2010-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "VA",
"license": "0001206629",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "504434",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "VA",
"license": "0024167388",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "DC",
"license": "RN1011287",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "CA",
"license": "1274",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "CT",
"license": "336",
"primary": true
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "MD",
"license": "AC00567",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CT",
"license": "89442",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.