Individual provider Active NPI

Leah Olivia Ross

  • Family Nurse Practitioner
  • Monticello, AR
National Provider Identifier
1104592955
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
216451 Issued in AR
Practice address
940 Old Warren Road
Monticello, AR 71655
Phone
(870) 377-3050
NPI assigned
Aug 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 216451 AR Primary

Addresses

Primary practice location

940 Old Warren Road
Monticello, AR 71655

Mailing address

104 South May Drive, Dumas, Ar, USA
Dumas, AR 71639
Phone (870) 377-3050

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
I20210929000400 AR Practitioner - Nurse Practitioner 7113324443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carmical Medical PLLCGroup PAC ID 3971909805, 8 clinicians

Practice addresses (Care Compare)

940 Old Warren Rd
Monticello, AR 71655-9717
Phone (870) 224-4411

Hospital & facility affiliations

  • Baptist Health Medical Center-Drew County Hospital, Monticello, AR, CCN 040051
  • Bradley County Medical Center Hospital, Warren, AR, CCN 041327
  • Baptist Health Medical Center-Little Rock Hospital, Little Rock, AR, CCN 040114
  • Ashley County Medical Center Hospital, Crossett, AR, CCN 041323

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carmical Medical PLLC CurrentSince Sep 21, 2021 Accepting new patients

Locations

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

940 Old Warren Rd
Monticello, AR 71655
Phone (870) 224-4411

Interoperability endpoints

  • Direct secure messaging: lross727152@direct.baptist-healthar.org
  • FHIR API: https://api.platform.athenahealth.com/23773/brand/1/csg/1/fhir/r4
  • Direct secure messaging: olivia.ross.1@23773.direct.athenahealth.com

Organizations & group practices 1

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 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": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1104592955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 SOUTH MAY DRIVE, DUMAS, AR, USA",
            "city": "DUMAS",
            "state": "AR",
            "postal_code": "71639",
            "telephone_number": "870-377-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 OLD WARREN ROAD",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "71655",
            "telephone_number": "870-377-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "LEAH",
        "middle_name": "OLIVIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-20",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "216451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, AR

Sources for this page

Verify at the official NPI Registry.