Individual provider Active NPI

Leon Hastings, MOT/L

  • Skilled Nursing Facility
  • Bridgeport, WV
National Provider Identifier
1144569583
Registry record updated Feb 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1121 Issued in WV
Practice address
415 Benedum Dr
Bridgeport, WV 26330-1503
Phone
(304) 842-9887
Fax
(304) 842-9888
NPI assigned
Feb 5, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1121 WV Primary

Addresses

Primary practice location

415 Benedum Dr
Bridgeport, WV 26330-1503

Mailing address

415 Benedum Dr
Bridgeport, WV 26330-1503
Phone (304) 842-9887

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131015001879 WV Practitioner - Occupational Therapist in Private Practice 6608924493 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1360022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360022400000",
    "number": "1144569583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 BENEDUM DR",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301503",
            "telephone_number": "304-842-9887",
            "fax_number": "304-842-9888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 BENEDUM DR",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301503",
            "telephone_number": "304-842-9887",
            "fax_number": "304-842-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASTINGS",
        "first_name": "LEON",
        "name_prefix": "Mr.",
        "credential": "MOT/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-05",
        "last_updated": "2013-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WV",
            "license": "1121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.