Leah Antunes, CMA
Individual provider Active NPI Exclusive Provider Organization · Lexington, SC
NPI 1154795615 · NPPES record last updated Jun 23, 2016
Key facts
- NPI
- 1154795615
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Exclusive Provider Organization 302F00000X
- License
- 47-5267829 (SC)
- Practice address
- 110 Mockingbird Dr
Lexington, SC 29073-8739 - Phone
- (803) 237-4103
- NPI assigned
- Nov 20, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Certified Medical Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 475267829 | SC | MD | Community/Behavioral Health Agency |
| 47-5267829 | SC | MD | Exclusive Provider Organization |
| 100295992 | SC | MD | Private Vehicle |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Exclusive Provider Organization | 302F00000X | 47-5267829 | SC | Yes |
| Driver | 172A00000X | 100295992 | SC | |
| Private Vehicle | 347C00000X | 100295992 | SC | |
| Voluntary or Charitable Agency | 251V00000X | 475267829 | SC | |
| Community/Behavioral Health Agency | 251S00000X | 475267829 | SC |
Addresses
Primary practice location
110 Mockingbird Dr
Lexington, SC 29073-8739
Mailing address
110 Mockingbird Dr
Lexington, SC 29073-8739
Phone (803) 237-4103
Other providers in Lexington, SC
- Brock James Anderson
- Kendall Anastasia Anderson
- Nicole Dunavant Anderson
- Anesthesiology Professionals of Columbia LLC
- Karina Antonio
- Briona Appleberry
- Eliza Jacob Appleby
- Abigail Applegate
- Anthony Allen Archer
- Archwood Counseling Services, LLC
All providers in Lexington, SC · Exclusive Provider Organization in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.