Individual provider Active NPI

Carrie Leach, PA-C

  • Physician Assistant
  • Grafton, WV
National Provider Identifier
1255684650
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1645 Issued in WV
Practice address
1 Hospital PLZ
Grafton, WV 26354-1283
Phone
(304) 265-6416
Fax
(304) 265-6417
NPI assigned
Oct 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 01645 WV
Physician Assistant 363A00000X 1645 WV Primary

Addresses

Primary practice location

1 Hospital PLZ
Grafton, WV 26354-1283

Mailing address

1 Hospital PLZ
Grafton, WV 26354-1283
Phone (304) 265-6416

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20160311000767 WV Practitioner - Physician Assistant 9436455763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Grandw IncGroup PAC ID 9739324922, 93 clinicians

Practice addresses (Care Compare)

1 Kenton Dr
Suite 200
Charleston, WV 25311-1256
Phone (304) 460-5123

1005 White Willow Way
Morgantown, WV 26505-6119
Phone (304) 460-5123

1100 Main St
Suite 104
Wheeling, WV 26003-2737
Phone (304) 460-5123

120 Professional PL
Bridgeport, WV 26330-4599
Phone (304) 460-5123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01645WVMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
GR&W, Inc PastSince Nov 18, 2025 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": "1350950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1255684650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL PLZ",
            "city": "GRAFTON",
            "state": "WV",
            "postal_code": "263541283",
            "telephone_number": "304-265-6416",
            "fax_number": "304-265-6417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL PLZ",
            "city": "GRAFTON",
            "state": "WV",
            "postal_code": "263541283",
            "telephone_number": "304-265-6416",
            "fax_number": "304-265-6417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEACH",
        "first_name": "CARRIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-23",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "01645",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "1645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grafton, WV

Sources for this page

Verify at the official NPI Registry.