Active NPI
Leon Ensalada
- Preventive Medicine/Occupational Environmental Medicine Physician
- Fort Bragg, NC
National Provider Identifier
1306011234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Preventive Medicine/Occupational Environmental Medicine Physician
- License
- 042-0010521
- Practice address
- Womack Army Medical Ctr
2817 Reilly Road MCXC-Cod Credentials
Fort Bragg, NC 28310-0001 - Phone
- (910) 907-8922
- Fax
- (910) 907-6069
- NPI assigned
- Apr 22, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Preventive Medicine/Occupational Environmental Medicine Physician | 2083P0500X | 042-0010521 | VT | Primary |
Addresses
Primary practice location
Womack Army Medical Ctr
2817 Reilly Road MCXC-Cod Credentials
Fort Bragg, NC 28310-0001
Mailing address
Womack Army Medical Ctr
2817 Reilly Road MCXC-Cod Credentials
Fort Bragg, NC 28310-0001
Phone (910) 907-8922
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042-0010521 | VT | MD | Preventive Medicine/Occupational Environmental Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208822400000",
"number": "1306011234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "WOMACK ARMY MEDICAL CTR",
"address_2": "2817 REILLY ROAD MCXC-COD CREDENTIALS",
"city": "FORT BRAGG",
"state": "NC",
"postal_code": "283100001",
"telephone_number": "910-907-8922",
"fax_number": "910-907-6069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "WOMACK ARMY MEDICAL CTR",
"address_2": "2817 REILLY ROAD MCXC-COD CREDENTIALS",
"city": "FORT BRAGG",
"state": "NC",
"postal_code": "283100001",
"telephone_number": "910-907-8922",
"fax_number": "910-907-6069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENSALADA",
"first_name": "LEON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-22",
"last_updated": "2008-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0500X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
"state": "VT",
"license": "042-0010521",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Bragg, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.