Individual provider Active NPI

Leslie K Elledge, CRNA

  • Certified Registered Nurse Anesthetist
  • Huntsville, AL
National Provider Identifier
1114249901
Registry record updated Sep 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-108714 Issued in AL
Practice address
245 Governors Dr SE
Huntsville, AL 35801-2700
Phone
(205) 979-5882
Fax
(205) 979-1248
NPI assigned
Feb 19, 2010
Last updated
Sep 9, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1-108714 AL Primary

Addresses

Primary practice location

245 Governors Dr SE
Huntsville, AL 35801-2700

Mailing address

PO Box 1389
Huntsville, AL 35807-0389
Phone (205) 979-5882

Other identifiers 3

IdentifierTypeStateIssuer
511-03149OtherALBC BS OF AL
1114249901OtherALTRICARE
120355MedicaidAL

Other names 1

  • Leslie K Denton Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100630000267 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385775634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Alabama School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Huntsville Hospital AnesthesiaGroup PAC ID 7315990751, 157 clinicians

Practice addresses (Care Compare)

245 Governors Dr SE
Huntsville, AL 35801-3784
Phone (256) 265-8120

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-108714ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Huntsville Hospital Anesthesia Nurse Anesthetist, Certified Registered CurrentSince Jan 22, 2010 Accepting new patients

Locations

101 Sivley Rd SW
Huntsville, AL 35801
Phone (256) 265-9870

201 Governors Dr SW
Huntsville, AL 35801
Phone (256) 265-6851

245 Governors Dr SE
Huntsville, AL 35801
Phone (256) 265-7673

8375 Highway 72 W
Madison, AL 35758
Phone (256) 265-2012

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1266537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378684800000",
    "number": "1114249901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1389",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358070389",
            "telephone_number": "205-979-5882",
            "fax_number": "205-979-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 GOVERNORS DR SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358012700",
            "telephone_number": "205-979-5882",
            "fax_number": "205-979-1248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLEDGE",
        "first_name": "LESLIE",
        "middle_name": "K",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-19",
        "last_updated": "2013-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-108714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF AL",
            "identifier": "511-03149",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1114249901",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120355",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "DENTON",
            "middle_name": "K",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.