Individual provider Active NPI

Leanne Metzger Carter, PA-C

  • Physician Assistant
  • Pine Bluff, AR
National Provider Identifier
1104450154
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-890 Issued in AR
Practice address
4747 Dusty Lake Dr Ste G1
Pine Bluff, AR 71603-9056
Phone
(870) 536-6600
Fax
(870) 541-8623
NPI assigned
Feb 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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 PA-890 AR Primary

Addresses

Primary practice location

4747 Dusty Lake Dr Ste G1
Pine Bluff, AR 71603-9056

Mailing address

4747 Dusty Lake Dr Ste G1
Pine Bluff, AR 71603-9056
Phone (870) 536-6600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address carterl@ohit.sharear.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20200327001540 AR Practitioner - Physician Assistant 4284063173 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson Hospital Association, IncGroup PAC ID 8123927431, 80 clinicians

Practice addresses (Care Compare)

1601 W 40TH Ave
Pine Bluff, AR 71603-6346

1609 W 40TH Ave
Pine Bluff, AR 71603-6319

1801 W 40TH Ave
Suite 6a
Pine Bluff, AR 71603-6963
Phone (870) 541-9373

1801 W 40TH St
6A Family Health Associates of Southeast Ar
Pine Bluff, AR 71603-6963
Phone (870) 541-9373

Hospital & facility affiliations

  • Jefferson Homecare Home health agency, White Hall, AR, CCN 047093
  • Jefferson Regional Medical Center Hospital, Pine Bluff, AR, CCN 040071

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA-890ARMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Hospital Association, Inc CurrentSince Mar 10, 2020 Accepting new patients
Jefferson Hospital Association, Inc CurrentSince Mar 10, 2020 Accepting new patients
Jefferson Hospital Assn, Inc. Past Accepting new patients
Jefferson Hospital Assn, Inc. Past Accepting new patients

Locations

4747 Dusty Lake Dr
Ste G1
Pine Bluff, AR 71603
Phone (870) 534-1188

4747 Dusty Lake Dr
Ste G2202
Pine Bluff, AR 71603

4747 Dusty Lake Dr
Ste 101
Pine Bluff, AR 71603
Phone (870) 536-6600

1609 W 40th Ave
Ste 403
Pine Bluff, AR 71603
Phone (870) 534-4188

1601 W 40th Ave
Ste 301
Pine Bluff, AR 71603
Phone (870) 541-4285

1801 W 40th Ave
Ste 6A
Pine Bluff, AR 71603
Phone (870) 541-7393

1600 W 40th Ave
Pine Bluff, AR 71603
Phone (870) 541-7100

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1582848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1104450154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4747 DUSTY LAKE DR STE G1",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716039056",
            "telephone_number": "870-536-6600",
            "fax_number": "870-541-8623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 DUSTY LAKE DR STE G1",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716039056",
            "telephone_number": "870-536-6600",
            "fax_number": "870-541-8623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "LEANNE",
        "middle_name": "METZGER",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-28",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "carterl@ohit.sharear.net",
            "affiliation": "N",
            "address_1": "4747 Dusty Lake Dr Ste G1",
            "city": "Pine Bluff",
            "state": "AR",
            "country_code": "US",
            "postal_code": "716039056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

Verify at the official NPI Registry.