Individual provider Active NPI

Alexis Michelle Leake, FNP-C

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1184388753
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5015316 Issued in NC
Practice address
7845 Little Ave
Charlotte, NC 28226-8198
Phone
(704) 375-0100
Fax
(704) 887-6450
NPI assigned
Oct 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 29712 SC
Family Nurse Practitioner 363LF0000X 5015316 NC Primary

Addresses

Primary practice location

7845 Little Ave
Charlotte, NC 28226-8198

Mailing address

PO Box 470408
Charlotte, NC 28247-0408
Phone (704) 375-0100

Other practice location 1

1061 Red Ventures Dr Ste 130
Fort Mill, SC 29707-2516
Phone (704) 375-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 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
I20220210000802 NC Practitioner - Nurse Practitioner 4385037522 Reassigns benefits to 1 organization
I20250131000477 SC Practitioner - Nurse Practitioner 4385037522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hospice and Palliative Care Charlotte RegionGroup PAC ID 1355331208, shared by 2 NPIs, 19 clinicians

Practice addresses (Care Compare)

1061 Red Ventures Dr
Suite 130
Fort Mill, SC 29707-2516
Phone (803) 548-3708

7845 Little Ave
Charlotte, NC 28226-8198
Phone (704) 375-0100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29712SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospice & Palliative Care Charlotte Region CurrentSince Oct 28, 2024 Accepting new patients
Hospice & Palliative Care Charlotte Region CurrentSince Oct 28, 2024 Accepting new patients
Hospice & Palliative Care Charlotte Region Past Accepting new patients

Locations

7845 Little Ave
Charlotte, NC 28226

1061 Red Ventures Dr
Ste 130
Fort Mill, SC 29707
Phone (803) 548-3708

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJDHDD

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": "1635379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1184388753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 470408",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282470408",
            "telephone_number": "704-375-0100",
            "fax_number": "704-887-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7845 LITTLE AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282268198",
            "telephone_number": "704-375-0100",
            "fax_number": "704-887-6450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1061 Red Ventures Dr Ste 130",
            "address_purpose": "LOCATION",
            "city": "Fort Mill",
            "state": "SC",
            "postal_code": "297072516",
            "country_code": "US",
            "telephone_number": "704-375-0100",
            "fax_number": "704-887-6450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEAKE",
        "first_name": "ALEXIS",
        "middle_name": "MICHELLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-28",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "29712",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5015316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.