NPIMap

Individual provider Active NPI

Quincy Adam Leach, AGACNP

  • Acute Care Nurse Practitioner
  • Sylacauga, AL
National Provider Identifier
1104301233
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1-076889 Issued in AL
Practice address
126 S Anniston Ave
Sylacauga, AL 35150-2904
Phone
(256) 872-7777
Fax
(256) 249-0863
NPI assigned
Sep 25, 2018
Last updated
Sep 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1-076889 AL Primary

Addresses

Primary practice location

126 S Anniston Ave
Sylacauga, AL 35150-2904

Mailing address

126 S Anniston Ave
Sylacauga, AL 35150-2904
Phone (256) 872-7777

Other practice location 1

315 W Hickory St
Sylacauga, AL 35150-2913
Phone (256) 401-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20190702000539 AL Practitioner - Nurse Practitioner 4486988045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

110 S Anniston Ave
Sylacauga, AL 35150-2961
Phone (256) 207-0200

315 W Hickory St
Sylacauga, AL 35150-2913
Phone (256) 401-4467

9518 US Hwy 231
Rockford, AL 35136-5214
Phone (256) 377-4366

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.03 of 100Reported as group
Quality
58.1
Promoting interoperability
96
Improvement activities
40
Cost
72

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Sylacauga Health Care Authority CurrentSince May 1, 2019 Accepting new patients
The Sylacauga Health Care Authority CurrentSince May 1, 2019 Accepting new patients
The Sylacauga Health Care Authority Past Accepting new patients
Healogics Specialty Physicians of Alabama, LLC PastSince Sep 29, 2019 Accepting new patients

Locations

9518 US Highway 231
Rockford, AL 35136
Phone (256) 377-4366

110 S Anniston Ave
Sylacauga, AL 35150
Phone (256) 207-0200

315 W Hickory St
Sylacauga, AL 35150
Phone (256) 249-5000

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 6

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": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1104301233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 S ANNISTON AVE",
            "city": "SYLACAUGA",
            "state": "AL",
            "postal_code": "351502904",
            "telephone_number": "256-872-7777",
            "fax_number": "256-249-0863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 S ANNISTON AVE",
            "city": "SYLACAUGA",
            "state": "AL",
            "postal_code": "351502904",
            "telephone_number": "256-872-7777",
            "fax_number": "256-249-0863"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 W Hickory St",
            "address_purpose": "LOCATION",
            "city": "Sylacauga",
            "state": "AL",
            "postal_code": "351502913",
            "country_code": "US",
            "telephone_number": "256-401-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEACH",
        "first_name": "QUINCY",
        "middle_name": "ADAM",
        "name_prefix": "Mr.",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-25",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-076889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylacauga, AL

Sources for this page

Verify at the official NPI Registry.