Individual provider Active NPI

Khye Sheng Andrei Leong, M.D.

  • Gastroenterology Physician
  • Jacksonville, NC
National Provider Identifier
1184672917
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
9800311 Issued in NC
Practice address
152 Memorial CT
Jacksonville, NC 28546-6322
Phone
(910) 353-3200
Fax
(910) 353-0600
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 9800311 NC Primary

Addresses

Primary practice location

152 Memorial CT
Jacksonville, NC 28546-6322

Mailing address

PO Box 986513
Department 100
Boston, MA 02298-6513
Phone (910) 219-8326

Other practice location 1

120 Memorial Dr
Jacksonville, NC 28546-6328
Phone (910) 353-0581

Other identifiers 2

IdentifierTypeStateIssuer
89126GKMedicaidNC
126GKOtherNCBCBS NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050824001094 NC Practitioner - Gastroenterology 3779514203 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Jacksonville Children'S and Multispecialty Clinic, PA Gastroenterology CurrentSince Nov 27, 2011 Accepting new patients
Jacksonville Behavior and Mental Health Current Accepting new patients
Amm Healthcare, PA CurrentSince May 22, 2022 Accepting new patients
Family Care Clinic, P.a. PastSince Nov 27, 2011 Accepting new patients
Meadows Lutcavage Smith Vinton Fidler & Long DDS PA PastSince Nov 27, 2011 Accepting new patients

Locations

114C Memorial Dr
Jacksonville, NC 28546
Phone (910) 346-3976

152 Memorial Ct
Jacksonville, NC 28546
Phone (910) 346-3976

120 Memorial Dr
Jacksonville, NC 28546
Phone (910) 353-0581

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1184672917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 986513",
            "address_2": "DEPARTMENT 100",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022986513",
            "telephone_number": "910-219-8326",
            "fax_number": "910-939-4269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 MEMORIAL CT",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466322",
            "telephone_number": "910-353-3200",
            "fax_number": "910-353-0600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285466328",
            "country_code": "US",
            "telephone_number": "910-353-0581",
            "fax_number": "910-353-1536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEONG",
        "first_name": "KHYE",
        "middle_name": "SHENG ANDREI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "9800311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89126GK",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NUMBER",
            "identifier": "126GK",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.