Individual provider Active NPI

Demetrich A. Leslie Jr.

  • Case Manager/Care Coordinator
  • Pickerington, OH
National Provider Identifier
1164334181
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
10400 Blacklick Eastern Rd
Pickerington, OH 43147-8235
Phone
(614) 726-7359
NPI assigned
Sep 22, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X OH Primary

Addresses

Primary practice location

10400 Blacklick Eastern Rd
Pickerington, OH 43147-8235

Mailing address

143 Rosehill Rd
Reynoldsburg, OH 43068-4332
Phone (269) 519-3619

Other identifiers 1

IdentifierTypeStateIssuer
0487170MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1164334181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 ROSEHILL RD",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430684332",
            "telephone_number": "269-519-3619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 BLACKLICK EASTERN RD",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "431478235",
            "telephone_number": "614-726-7359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESLIE",
        "first_name": "DEMETRICH",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-22",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0487170",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pickerington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.