Active NPI
Leeann Harridsleff
- Physician Assistant
- Jacksonville, FL
National Provider Identifier
1265816649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9108775
- Practice address
- 6500 Bowden Rd
Suite 103
Jacksonville, FL 32216-8070 - Phone
- (904) 634-0640
- NPI assigned
- Jul 15, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9108775 | FL | Primary |
Addresses
Primary practice location
6500 Bowden Rd
Suite 103
Jacksonville, FL 32216-8070
Mailing address
6500 Bowden Rd
Suite 103
Jacksonville, FL 32216-8070
Phone (904) 634-0640
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9108775 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Orthopedic Specialists, LLC | Past | Accepting new patients |
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.
-
- Orthopaedic Surgery Physician
- Jacksonville, FL
- NPI 1629025820
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437004800000",
"number": "1265816649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6500 BOWDEN RD",
"address_2": "SUITE 103",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322168070",
"telephone_number": "904-634-0640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6500 BOWDEN RD",
"address_2": "SUITE 103",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322168070",
"telephone_number": "904-634-0640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIDSLEFF",
"first_name": "LEEANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-15",
"last_updated": "2015-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9108775",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.