Individual provider Active NPI

Leah Marie Brown, NP

  • Nurse Practitioner
  • Poway, CA
National Provider Identifier
1215166202
Registry record updated Jul 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
19029 Issued in CA
Practice address
15525 Pomerado Rd
Suite A2
Poway, CA 92064-2435
Phone
(858) 451-3311
NPI assigned
Jul 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 19029 CA Primary

Addresses

Primary practice location

15525 Pomerado Rd
Suite A2
Poway, CA 92064-2435

Mailing address

15525 Pomerado Rd
Suite A2
Poway, CA 92064-2435
Phone (858) 451-3311

Other names 1

  • Leah Marie Larson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20090922000602 CA Practitioner - Nurse Practitioner 3678629391 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bernardo Dermatology Medical Group Inc CurrentSince Jul 13, 2009 Accepting new patients

Locations

15525 Pomerado Rd
Ste A2
Poway, CA 92064
Phone (858) 451-3311

Interoperability endpoints

  • Direct secure messaging: leah.brown.1@24068.direct.athenahealth.com

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": "1247184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374451200000",
    "number": "1215166202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15525 POMERADO RD",
            "address_2": "SUITE A2",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642435",
            "telephone_number": "858-451-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15525 POMERADO RD",
            "address_2": "SUITE A2",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642435",
            "telephone_number": "858-451-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "LEAH",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-10",
        "last_updated": "2013-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "19029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEAH",
            "last_name": "LARSON",
            "middle_name": "MARIE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Poway, CA

Sources for this page

Verify at the official NPI Registry.