Leslie M Hollis, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

K3589 Issued in TX

Practice address

2014 Ben Merritt Dr Ste B
Decatur, TX 76234-3851

Phone

(940) 627-4400

Fax

(940) 626-4411

NPI assigned

May 10, 2006

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 identifiers 2

Other names 1

• Leslie M Kennedy Other name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lesliehollis@wise.allscriptsdirect.net
• Direct secure messaging: leslie.hollis.1@11284.direct.athenahealth.com

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.

• Jack County Hospital District

  dba Faith Community Hospital

  • General Acute Care Hospital
  • Jacksboro, TX
  • NPI 1790777696
  Medicare reassignment NPD
• Wise Clinical Care Associates

  • Family Medicine Physician
  • Bridgeport, TX
  • NPI 1679719801

  Pediatrics

  Medicare reassignment NPD
• Decatur Hospital Authority

  dba Wise Health System

  • Skilled Nursing Facility
  • Decatur, TX
  • NPI 1124076401
  NPD
• Jack County Hospital District

  • Rural Acute Care Hospital
  • Bowie, TX
  • NPI 1982460705
  NPD
• Wise Clinical Care Associates

  • Urgent Care Clinic/Center
  • Haslet, TX
  • NPI 1386112506
  NPD (past)

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1275582777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2078",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762346156",
            "telephone_number": "940-627-4400",
            "fax_number": "940-626-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 BEN MERRITT DR STE B",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762343851",
            "telephone_number": "940-627-4400",
            "fax_number": "940-626-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIS",
        "first_name": "LESLIE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K3589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8GN062",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092399705",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "KENNEDY",
            "middle_name": "M",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amber Danell Higgs, OT
• Olivia Hillard, WHNP-BC
• Bailey Hodges, RN
• Sven Peder Hoge, DMD
• Christine W Holland, MD
• Sammy Joe Horton, M.D.
• Meagan Host
• Adam Lucas Hotaling, ATC, LAT
• Melissa House, APN
• Julianne Howdeshell, LCSW

• Pediatrics Physician in Decatur, TX
• Providers in Decatur, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.