Individual provider Active NPI

Leanza Sidey

  • Physical Therapist
  • Wilmington, NC
National Provider Identifier
1265107262
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P24270 Issued in NC
Practice address
4829 Carolina Beach Rd Ste 100
Wilmington, NC 28412-2366
Phone
(910) 444-0020
NPI assigned
Aug 11, 2021
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness Coach 171400000X
Physical Therapist 225100000X P24270 NC Primary

Addresses

Primary practice location

4829 Carolina Beach Rd Ste 100
Wilmington, NC 28412-2366

Mailing address

423 Mallard Dr
Pineville, NC 28134-7561
Phone (980) 229-2604

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250827003954 NC Practitioner - Physical Therapist in Private Practice 6103327655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthy SeniorsGroup PAC ID 5193155695, 11 clinicians

Practice addresses (Care Compare)

4829 Carolina Beach Rd
Suite 100
Wilmington, NC 28412-2366
Phone (910) 444-0020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P24270NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Seniors CurrentSince Aug 12, 2025 Accepting new patients

Locations

4829 Carolina Beach Rd
Ste 100
Wilmington, NC 28412
Phone (910) 444-0020

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1265107262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 MALLARD DR",
            "city": "PINEVILLE",
            "state": "NC",
            "postal_code": "281347561",
            "telephone_number": "980-229-2604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4829 CAROLINA BEACH RD STE 100",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122366",
            "telephone_number": "910-444-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDEY",
        "first_name": "LEANZA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-11",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P24270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.