Kelley Manion Leonard, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95002404 Issued in CA

Practice address

2545 E Bidwell St Ste 110
Folsom, CA 95630-6443

Phone

(916) 941-7362

Fax

(866) 779-3899

NPI assigned

Apr 6, 2011

Last updated

Dec 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

• Folsom Family and Sports Medical Group Inc.

  • Family Medicine Physician
  • Folsom, CA
  • NPI 1629372073
  Medicare reassignment NPD

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1275822520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 E BIDWELL ST STE 110",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956306443",
            "telephone_number": "916-941-7362",
            "fax_number": "866-779-3899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 E BIDWELL ST STE 110",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956306443",
            "telephone_number": "916-941-7362",
            "fax_number": "866-779-3899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "KELLEY",
        "middle_name": "MANION",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-06",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-087100",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9212041",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-087100",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95002404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connor Leishman, DPT
• Lena Home Care Group LLC (Love Life Senior Care)
• Lisa J Lennox, M.A., CCC-SLP
• Christine Marie Leon, PA-C
• Bryan Robert Leonard, NP
• Gabriela Lepadat
• Jessica Lepage-Smith, LCSW
• Lauren Lerza, PSY.D.
• Charles CHI Hao Leung, DDS
• Annemarie Renee Leuschen

• Family Nurse Practitioner in Folsom, CA
• Providers in Folsom, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; 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.