Ledro Justice, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

R-4656 Issued in AR

Practice address

1401 S 4TH St
Philadelphia, PA 19147-5948

Phone

(479) 629-0658

NPI assigned

Sep 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

• Tanner Medical Group Inc

  • Cardiovascular Disease Physician
  • Carrollton, GA
  • NPI 1396979787
  NPD (past)

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1306948526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2023 PARKRIDGE DR",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729567487",
            "telephone_number": "479-629-0658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S 4TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191475948",
            "telephone_number": "479-629-0658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTICE",
        "first_name": "LEDRO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "AR",
            "license": "R-4656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justee Home Health Care LLC
• Justforyourtiming Homecare
• Justice Homecare LLC
• Jessica Lee Justice Vogt, PA-C
• Joy Marie Justice
• Travis Logan Justice, BA, CADC
• William Justice, MD
• Judith I. Justman, M.D.
• Monica Regina Jutkowitz, M.S.W.
• Juvenile Jusice Center of Philadelphia (JJC Family Services)

• Child & Adolescent Psychiatry Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Child & Adolescent Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; 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.