Andrew T Leebolt, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5357 Issued in TN

Practice address

215 Brightwater Drive
Lillington, NC 27546

Phone

(910) 892-1000

NPI assigned

Jun 16, 2019

Last updated

Apr 29, 2025By 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 4

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, VA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Emergency Medicine

Education

Edward Via Col of Osteo Medicine-Virginia Campus, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Western Virginia Regional Emergency Physicians LLCGroup PAC ID 4183991227, 88 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Smyth County Community Hospital Hospital, Marion, VA, CCN 490038

Merit-based Incentive Payment System (MIPS)

Final score

90.33 of 100Reported as group

Quality

83.8

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

75.12 of 100Reported as group

Quality

64.75

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Western Virginia Regional Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Norton, VA
  • NPI 1386183028
  Medicare reassignment Care Compare group NPD
• Blue Ridge Medical Management Corporation

  dba First Assist Urgent Care

  • Urgent Care Clinic/Center
  • Elizabethton, TN
  • NPI 1144380833
  Medicare reassignment NPD
• Tri-Cities Regional Emergency Physicians, PC

  • Emergency Medicine Physician
  • Johnson City, TN
  • NPI 1063950046
  Medicare reassignment NPD
• Blue Ridge Medical Management Corporation

  dba Ballad Health

  • Internal Medicine Physician
  • Erwin, TN
  • NPI 1538989371
  NPD
• Blue Ridge Medical Management Corporation

  dba Ballad Health Medical Associates

  • Family Medicine Physician
  • Johnson City, TN
  • NPI 1982553756
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Smyth County Community Hospital

  • General Acute Care Hospital
  • Marion, VA
  • NPI 1073519377
  Care Compare affiliation
• Smyth County Community Hospital

  dba Center for Sleep Disorders at SCCH

  • General Acute Care Hospital
  • Marion, VA
  • NPI 1194104687
  Care Compare affiliation
• Smyth County Community Hospital

  • Durable Medical Equipment & Medical Supplies
  • Marion, VA
  • NPI 1750433389

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1560643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1104486885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 BRIGHTWATER DRIVE",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "27546",
            "telephone_number": "910-892-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 BRIGHTWATER DRIVE",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "27546",
            "telephone_number": "910-892-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 S Mohawk Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Erwin",
            "state": "TN",
            "postal_code": "376502124",
            "country_code": "US",
            "telephone_number": "423-735-0500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEEBOLT",
        "first_name": "ANDREW",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-16",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "5357",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0102208637",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102208637",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "5357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Darroch Lawson, PA-C
• Kimberly Dawn Leaird, PT
• Shannon Renee Lebakken
• Ashley Jones Ledford, MA, CCC-SLP
• Julia Ashton Ledgett, PA
• Alina Leonhardt, RN
• Alexandrea Elmore Lesnoff, LCSWA
• Eric Michael Levan, PHARM.D.
• Anna Finestone Leviere
• Lara Webb Liles, RPH.

• Family Medicine Physician in Lillington, NC
• Providers in Lillington, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.