Charles Edwin Leonard, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

122284 Issued in TN

Practice address

1171 Highway 11 E
Suite 101
Talbott, TN 37877-3137

Phone

(865) 475-2400

NPI assigned

Feb 22, 2006

Last updated

Jan 19, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263859200000",
    "number": "1114992260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1171 HIGHWAY 11 E",
            "address_2": "SUITE 101",
            "city": "TALBOTT",
            "state": "TN",
            "postal_code": "378773137",
            "telephone_number": "865-475-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 HIGHWAY 11 E",
            "address_2": "SUITE 101",
            "city": "TALBOTT",
            "state": "TN",
            "postal_code": "378773137",
            "telephone_number": "865-475-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "CHARLES",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2010-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "122284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3185546",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Rae Krohn, MS
• Mercedes Kuster
• Dakya Jashae Kyle-Long
• Lakeway Anesthesia Inc.
• Pamela Christine Lamb, LPC-MHSP (TEMP)
• Jeremy Loveall, R.N.
• Amanda Hope Lowe-Sizemore, R.N.
• Alea Lowe
• Laura Lukac
• Kristin Kai Mahoney, PHD

• Family Medicine Physician in Talbott, TN
• Providers in Talbott, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.