Individual provider Active NPI

Leigh Chiasson

  • Physical Therapist
  • Vancleave, MS
National Provider Identifier
1174386015
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-7311 Issued in MS
Practice address
6300 E Lake Blvd Ste 101
Vancleave, MS 39565-6771
Phone
(228) 818-1200
NPI assigned
Feb 2, 2024
Last updated
Apr 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-7311 MS Primary

Addresses

Primary practice location

6300 E Lake Blvd Ste 101
Vancleave, MS 39565-6771

Mailing address

42465 Highway 195
Haleyville, AL 35565-7052
Phone (256) 350-1764

Other names 1

  • Leigh Beaver Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240402000882 MS Practitioner - Physical Therapist in Private Practice 7719325307 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Fitness Clinic WellnessGroup PAC ID 4486938719, 9 clinicians
Family Physical Therapy of South MsGroup PAC ID 0941217335, 5 clinicians
Bienville Therapy, LLCGroup PAC ID 1254878325, 24 clinicians

Practice addresses (Care Compare)

Madison, MS 39110
Phone (601) 983-7494

19020 Pineville Rd
Suite 4
Long Beach, MS 39560-4572
Phone (228) 863-4080

6300 E Lake Blvd
Suite 101
Vancleave, MS 39565-6771
Phone (228) 215-2240

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-7311MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bienville Therapy, LLC Physical Therapist CurrentSince May 20, 2024 Accepting new patients
Bienville Orthopaedic Specialists, LLC CurrentSince Jan 1, 2024 Accepting new patients
Bienville Orthopaedic Specialists, LLC CurrentSince Jan 1, 2024 Accepting new patients
Bienville Therapy, LLC Physical Therapist CurrentSince May 20, 2024 Accepting new patients
Bienville Therapy, LLC Physical Therapist CurrentSince Apr 21, 2024 Accepting new patients
Family Physical Therapy of South Ms CurrentSince Aug 4, 2025 Accepting new patients
Fitness Clinic Wellness Physical Therapist CurrentSince Jan 1, 2026 Accepting new patients

Locations

42465 Highway 195
Haleyville, AL 35565
Phone (205) 486-2753

1720A Medical Park Dr
Ste 220
Biloxi, MS 39532
Phone (228) 392-9355

19020 Pineville Rd
Ste 4
Long Beach, MS 39560
Phone (228) 863-4080

3615 Hospital St
Pascagoula, MS 39581
Phone (228) 762-3664

3615 Hospital St
#B
Pascagoula, MS 39581
Phone (228) 215-2260

6300 E Lake Blvd
Ste 101
Vancleave, MS 39565
Phone (228) 215-2240

6300 E Lake Blvd
Ste 201
Vancleave, MS 39565
Phone (228) 206-2263

6300 E Lake Blvd
Ste 301
Vancleave, MS 39565

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1174386015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42465 HIGHWAY 195",
            "city": "HALEYVILLE",
            "state": "AL",
            "postal_code": "355657052",
            "telephone_number": "256-350-1764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 E LAKE BLVD STE 101",
            "city": "VANCLEAVE",
            "state": "MS",
            "postal_code": "395656771",
            "telephone_number": "228-818-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIASSON",
        "first_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT-7311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEIGH",
            "last_name": "BEAVER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vancleave, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.