Individual provider Active NPI

Nicole Natasha McLeod, PMHNP

  • Psychiatry Physician
  • Abingdon, MD
National Provider Identifier
1194308320
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
R204469 Issued in MD
Practice address
2794 Sugar Pine CT
Abingdon, MD 21009-1588
Phone
(610) 299-4704
NPI assigned
May 5, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X R204469 MD Primary

Addresses

Primary practice location

2794 Sugar Pine CT
Abingdon, MD 21009-1588

Mailing address

2794 Sugar Pine CT
Abingdon, MD 21009-1588
Phone (610) 299-4704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210728000489 MD Practitioner - Nurse Practitioner 1052714078 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

Practice addresses (Care Compare)

2794 Sugar Pine CT
Abingdon, MD 21009-1588
Phone (954) 547-3675

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R204469MDMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Karis Treatment Center CurrentSince Jul 1, 2021 Accepting new patients

Organizations & group practices 1

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": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1194308320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2794 SUGAR PINE CT",
            "city": "ABINGDON",
            "state": "MD",
            "postal_code": "210091588",
            "telephone_number": "610-299-4704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2794 SUGAR PINE CT",
            "city": "ABINGDON",
            "state": "MD",
            "postal_code": "210091588",
            "telephone_number": "610-299-4704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEOD",
        "first_name": "NICOLE",
        "middle_name": "NATASHA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-05",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "R204469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abingdon, MD

Sources for this page

Verify at the official NPI Registry.