Individual provider Active NPI

Leslie Tabb, NP

  • Family Nurse Practitioner
  • Cleveland, MS
National Provider Identifier
1316916844
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R855837 Issued in MS
Practice address
803 1St St
Cleveland, MS 38732-2309
Phone
(662) 843-2721
NPI assigned
Mar 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R855837 MS Primary

Addresses

Primary practice location

803 1St St
Cleveland, MS 38732-2309

Mailing address

803 1St St
Cleveland, MS 38732-2309
Phone (662) 843-2721

Other identifiers 2

IdentifierTypeStateIssuer
500011524OtherMSMEDICARE RAILROAD
00121836MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20060411000336 MS Practitioner - Nurse Practitioner 0042229502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Medical Clinic of Cleveland, LLCGroup PAC ID 9335306497, 6 clinicians

Practice addresses (Care Compare)

803 1St St
Cleveland, MS 38732-2309
Phone (662) 843-2721

Hospital & facility affiliations

  • Bolivar Medical Center Hospital, Cleveland, MS, CCN 250093

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical Clinic of Cleveland, LLC Family CurrentSince Jun 2, 2000 Accepting new patients

Locations

803 1st St
Cleveland, MS 38732
Phone (601) 843-2721

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1316916844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 1ST ST",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387322309",
            "telephone_number": "662-843-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 1ST ST",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387322309",
            "telephone_number": "662-843-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABB",
        "first_name": "LESLIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R855837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "500011524",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00121836",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, MS

Sources for this page

Verify at the official NPI Registry.