Jennifer Ann Leary, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

2012033858 Issued in MO

Practice address

11365 Dorsett Rd
Maryland Heights, MO 63043-3411

Phone

(314) 872-6400

Fax

(314) 872-6500

NPI assigned

Oct 14, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Ranken-Jordan Home for Convalescent Crippled Children

  • General Acute Care Hospital
  • Maryland Heights, MO
  • NPI 1235117532
  NPD (past)

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

{
    "created_epoch": "1350172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350172800000",
    "number": "1285986323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11365 DORSETT RD",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630433411",
            "telephone_number": "314-872-6400",
            "fax_number": "314-872-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11365 DORSETT RD",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630433411",
            "telephone_number": "314-872-6400",
            "fax_number": "314-872-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEARY",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-14",
        "last_updated": "2012-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "149995",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2012033858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Laffoon
• Theodore Langham
• Charles S Larsen, D.O.
• Tiara Isis Lashley
• Brittany Elizabeth Lazear
• Susan Lenny, PHARM.D.
• Amy Renee Leuthauser, BCBA
• Phylicia Little, FNP-BC
• Ashley Liu, PHARMD
• Living Well Consumer Directed Services, LLC

• Pediatric Nurse Practitioner in Maryland Heights, MO
• Providers in Maryland Heights, MO by specialty
• Pediatric Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.