Individual provider Active NPI

Leslie Marie Kennedy, NP-C

  • Family Nurse Practitioner
  • Central Falls, RI
National Provider Identifier
1114400256
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN04983 Issued in RI
Practice address
1000 Broad St
Central Falls, RI 02863-1507
Phone
(401) 722-0081
NPI assigned
Sep 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN04983 RI Primary
Family Nurse Practitioner 363LF0000X APN0997082NP CO
Family Nurse Practitioner 363LF0000X 209018394 IL
Family Nurse Practitioner 363LF0000X 4704347248 MI

Addresses

Primary practice location

1000 Broad St
Central Falls, RI 02863-1507

Mailing address

39 East Ave
Pawtucket, RI 02860-4003
Phone (401) 312-5247

Other names 1

  • Leslie Marie Theisen Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, RI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250304000877 CO Practitioner - Nurse Practitioner 3577804889 Reassigns benefits to 1 organization
I20260622002230 RI Practitioner - Nurse Practitioner 3577804889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Boston University School of Medicine, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1332 Muirwood CT
Rochester Hills, MI 48306-3791

39 E Ave
Pawtucket, RI 02860-4003

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN0997082NPCOMDFamily Nurse Practitioner
209018394ILMDFamily Nurse Practitioner
APRN04983RIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Campesina Family Health Services Current Accepting new patients
Clinica Campesina Family Health Services CurrentSince Dec 30, 2024 Accepting new patients

Locations

1735 S Public Rd
Lafayette, CO 80026
Phone 30366530361061

1735 S Public Rd
Ste 203
Lafayette, CO 80026

8510 Bryant St
Ste 200
Westminster, CO 80031
Phone (303) 449-6050

Organizations & group practices 3

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": "1536883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1114400256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 EAST AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028604003",
            "telephone_number": "401-312-5247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BROAD ST",
            "city": "CENTRAL FALLS",
            "state": "RI",
            "postal_code": "028631507",
            "telephone_number": "401-722-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "LESLIE",
        "middle_name": "MARIE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-14",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "APRN04983",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN0997082NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209018394",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704347248",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "THEISEN",
            "middle_name": "MARIE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Central Falls, RI

Sources for this page

Verify at the official NPI Registry.