Individual provider Active NPI

Leah Baxter Tindall, MD

  • Internal Medicine Physician
  • College Station, TX
National Provider Identifier
1215040183
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
K3025 Issued in TX
Practice address
1605 Rock Prairie Rd
Ste 212
College Station, TX 77845-8358
Phone
(979) 680-0361
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X K3025 TX Primary

Addresses

Primary practice location

1605 Rock Prairie Rd
Ste 212
College Station, TX 77845-8358

Mailing address

1003 Hemingway Dr
College Station, TX 77845-5687
Phone (979) 694-9954

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20131212000058 TX Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 5193952497

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas a&M University System Health Science Center Past Accepting new patients
Family Practice Foundation of the Brazos Valley Past Accepting new patients

Organizations & group practices 2

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215040183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 HEMINGWAY DR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778455687",
            "telephone_number": "979-694-9954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 ROCK PRAIRIE RD",
            "address_2": "STE 212",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458358",
            "telephone_number": "979-680-0361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINDALL",
        "first_name": "LEAH",
        "middle_name": "BAXTER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K3025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

Verify at the official NPI Registry.