Leisa Jamine Hospedales, AGPCNP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

APRN11021939 Issued in FL

Practice address

135 E 1St St
Lakeland, FL 33805-4609

Phone

(863) 686-2728

Fax

(863) 686-6737

NPI assigned

Oct 24, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Leisa Jamine Small Former name

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Medical Director Services PCGroup PAC ID 0042501116, 79 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Medical Director Services PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Princess Anne, MD
  • NPI 1871955807

  NY

  Medicare reassignment Care Compare group NPD
• JDS Medical Services PC

  • Emergency Medicine Physician
  • Englewood, NJ
  • NPI 1174224653

  NY

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1245957091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15118 EVANS RANCH RD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338099714",
            "telephone_number": "863-510-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 E 1ST ST",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054609",
            "telephone_number": "863-686-2728",
            "fax_number": "863-686-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSPEDALES",
        "first_name": "LEISA",
        "middle_name": "JAMINE",
        "name_prefix": "Ms.",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-24",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11021939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEISA",
            "last_name": "SMALL",
            "middle_name": "JAMINE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cindy Jo Horrell, ARNP
• Patrick Horrell, ARNP
• Leah Horst, OTD, OTR/L
• Christopher Horton
• Casey Lynn Hosegood, PTA, ATC
• Joan Hou, M.D.
• Gena Hough, PT
• Mickelyn Graves Houghton, APRN-CNM
• Stacy Ann Houghton, ARNP
• House 3730 LLC

• Adult Health Nurse Practitioner in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.