Individual provider Active NPI

Leann Nicole Smoot, PA-C

  • Physician Assistant
  • Germantown, TN
National Provider Identifier
1174930259
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1325 Wolf Park Dr Ste 102
Germantown, TN 38138-1759
Phone
(901) 252-3400
Fax
(901) 763-4305
NPI assigned
Jul 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1325 Wolf Park Dr Ste 102
Germantown, TN 38138-1759

Mailing address

1325 Wolf Park Dr Ste 103
Germantown, TN 38138-1759
Phone (901) 252-3400

Other practice location 1

3145 Players Club Pkwy
Memphis, TN 38125-8835
Phone (901) 252-3400

Other practice location 2

125 Guthrie Dr
Southaven, MS 38671-5829
Phone (901) 252-3400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20141125000381 MS Practitioner - Physician Assistant 0345562542 Reassigns benefits to 1 organization
I20230705002225 TN Practitioner - Physician Assistant 0345562542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Conrad Pearson Clinic PCGroup PAC ID 7315832649, 23 clinicians

Practice addresses (Care Compare)

125 Guthrie Dr
Southaven, MS 38671-5829
Phone (662) 349-1964

1325 Wolf Park Dr
Germantown, TN 38138-1759
Phone 90125234113495

3145 Players Club Pkwy
Memphis, TN 38125-8835
Phone (901) 252-3400

Merit-based Incentive Payment System (MIPS)

Final score
87.76 of 100Reported as group
Quality
69.4
Promoting interoperability
100
Improvement activities
40
Cost
89.8

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Conrad Pearson Clinic PC CurrentSince Aug 1, 2023 Accepting new patients
Conrad Pearson Clinic PC CurrentSince Aug 1, 2023 Accepting new patients
Conrad Pearson Clinic PastSince Jul 2, 2023 Accepting new patients

Locations

125 Guthrie Dr
Southaven, MS 38671
Phone (601) 349-1964

1325 Wolf Park Dr
Ste 103
Memphis, TN 38138

3145 Players Club Pkwy
Memphis, TN 38125
Phone (901) 252-3400

1325 Wolf Park Dr
Ste 102
Memphis, TN 38138
Phone (901) 252-3400

Interoperability endpoints

  • Direct secure messaging: leann.smoot.p1@direct.cpc.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1174930259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 WOLF PARK DR STE 103",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381759",
            "telephone_number": "901-252-3400",
            "fax_number": "901-763-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 WOLF PARK DR STE 102",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381759",
            "telephone_number": "901-252-3400",
            "fax_number": "901-763-4305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3145 Players Club Pkwy",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381258835",
            "country_code": "US",
            "telephone_number": "901-252-3400",
            "fax_number": "901-763-4305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 Guthrie Dr",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386715829",
            "country_code": "US",
            "telephone_number": "901-252-3400",
            "fax_number": "901-763-4305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMOOT",
        "first_name": "LEANN",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-21",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.