Individual provider Active NPI

Leslie B Pearson, NP

  • Family Nurse Practitioner
  • Southaven, MS
National Provider Identifier
1114445764
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
902137 Issued in MS
Practice address
401 Southcrest Cir Ste 212
Southaven, MS 38671-6721
Phone
(662) 245-5270
Fax
(662) 351-9471
NPI assigned
Sep 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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 902137 MS Primary

Addresses

Primary practice location

401 Southcrest Cir Ste 212
Southaven, MS 38671-6721

Mailing address

401 Southcrest Cir Ste 212
Southaven, MS 38671-6721
Phone (662) 245-5270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20180907001115 MS Practitioner - Nurse Practitioner 4183989189 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wound Care Associates LLCGroup PAC ID 0840314548, 117 clinicians

Practice addresses (Care Compare)

401 Southcrest Cir
Southaven, MS 38671-6726
Phone (985) 892-7070

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
902137MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Triangle Urgent Care LLC Family CurrentSince Apr 3, 2023 Accepting new patients
Wound Care Associates LLC CurrentSince May 30, 2024 Accepting new patients
Webster Health Services, Inc. CurrentSince Jul 14, 2020 Accepting new patients
Golden Triangle Urgent Care LLC Family CurrentSince Apr 3, 2023 Accepting new patients
Webster Health Services, Inc. CurrentSince Jul 14, 2020 Accepting new patients

Locations

16065 Lamonte Dr
Hammond, LA 70403
Phone (985) 956-7771

70 Medical Plz
Eupora, MS 39744
Phone (662) 258-6221

431 W Race St
Rolling Fork, MS 39159
Phone (662) 795-0440

401 Southcrest Cir
Ste 212
Southaven, MS 38671
Phone (662) 245-5270

500 Russell St
Ste 3
Starkville, MS 39759
Phone (662) 324-2244

925 Calhoun Ave
Yazoo City, MS 39194
Phone (662) 746-6651

Organizations & group practices 6

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 3

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": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1114445764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 SOUTHCREST CIR STE 212",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386716721",
            "telephone_number": "662-245-5270",
            "fax_number": "662-351-9471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 SOUTHCREST CIR STE 212",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386716721",
            "telephone_number": "662-245-5270",
            "fax_number": "662-351-9471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "LESLIE",
        "middle_name": "B",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-05",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.