Individual provider Active NPI

Jacqueline Ledford, AGNP

  • Adult Health Nurse Practitioner
  • Salisbury, NC
National Provider Identifier
1134798390
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
LEDF-ZCLRX Issued in NC
Practice address
611 Mocksville Ave
Salisbury, NC 28144-2705
Phone
(704) 633-7220
NPI assigned
Jun 22, 2021
Last updated
Oct 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X LEDF-ZCLRX NC Primary

Addresses

Primary practice location

611 Mocksville Ave
Salisbury, NC 28144-2705

Mailing address

611 Mocksville Ave
Salisbury, NC 28144-2786
Phone (704) 633-7220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20211111001653 NC Practitioner - Nurse Practitioner 4688063720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rowan Diagnostic Clinic PAGroup PAC ID 9335037944, 27 clinicians

Practice addresses (Care Compare)

611 Mocksville Ave
Salisbury, NC 28144-2705
Phone (704) 633-7220

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LEDF-ZCLRXNCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rowan Diagnostic Clinic P.a. CurrentSince Nov 1, 2021 Accepting new patients
Rowan Diagnostic Clinic P.a. Current Accepting new patients
Rowan Diagnostic Clinic, PA CurrentSince Nov 1, 2021 Accepting new patients

Locations

611 Mocksville Ave
Salisbury, NC 28144
Phone 7046337220269

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, 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": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1134798390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 MOCKSVILLE AVE",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442786",
            "telephone_number": "704-633-7220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 MOCKSVILLE AVE",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442705",
            "telephone_number": "704-633-7220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDFORD",
        "first_name": "JACQUELINE",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "LEDF-ZCLRX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, NC

Sources for this page

Verify at the official NPI Registry.