Individual provider Active NPI

James C Leadingham, O.D., PSC

  • Optometrist
  • Louisa, KY
National Provider Identifier
1104814599
Registry record updated Feb 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0731DT Issued in KY
Practice address
112 Vinson Blvd
Louisa, KY 41230-1155
Phone
(606) 638-4731
Fax
(606) 638-3523
NPI assigned
Oct 10, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0731DT KY Primary

Addresses

Primary practice location

112 Vinson Blvd
Louisa, KY 41230-1155

Mailing address

112 Vinson Blvd
Louisa, KY 41230
Phone (606) 638-4731

Other identifiers 6

IdentifierTypeStateIssuer
77007318MedicaidKY
000000305678OtherKYBCBS
0149556000MedicaidWV
1432032OtherKYUNITED MINE WORKERS H&R
P00134006OtherKYRAILROAD MEDICARE
610980551OtherKYTAX ID

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

State licenses

LicenseStateTypeSpecialty
0731DTKYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
William E Leadingham, OD, PSC Optometrist Past Accepting new patients
Leadingham Eye Care Center - Ashland Optometrist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360195200000",
    "number": "1104814599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 VINSON BLVD",
            "city": "LOUISA",
            "state": "KY",
            "postal_code": "41230",
            "telephone_number": "606-638-4731",
            "fax_number": "606-638-3523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 VINSON BLVD",
            "city": "LOUISA",
            "state": "KY",
            "postal_code": "412301155",
            "telephone_number": "606-638-4731",
            "fax_number": "606-638-3523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEADINGHAM",
        "first_name": "JAMES",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "O.D., PSC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2013-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "0731DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77007318",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000305678",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0149556000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED MINE WORKERS H&R",
            "identifier": "1432032",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00134006",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "610980551",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisa, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.