Individual provider Active NPI

Jennifer Leidy, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Edgewood, KY
National Provider Identifier
1346561008
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
58393 Issued in KY
Practice address
1 Medical Village Dr
Edgewood, KY 41017-3403
Phone
(859) 301-2018
Fax
(859) 301-2073
NPI assigned
Jun 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 01090000A IN
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 0101269191 VA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 245525 MA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 58393 KY Primary

Addresses

Primary practice location

1 Medical Village Dr
Edgewood, KY 41017-3403

Mailing address

PO Box 636324
Cincinnati, OH 45263-6324
Phone (859) 301-2018

Other practice location 1

1 Innovation Dr Ste 3
Pathology Residency
Worcester, MA 01605-4306
Phone (508) 334-1000

Other practice location 2

44045 Riverside Pkwy
Leesburg, VA 20176-5101
Phone (703) 858-6000

Other practice location 3

3300 Gallows Rd
Falls Church, VA 22042-3300
Phone (703) 776-4001

Other practice location 4

4320 Seminary Rd
Alexandria, VA 22304-1535
Phone (703) 504-3000

Other practice location 5

2832 Juniper St
Fairfax, VA 22031-4402
Phone (703) 645-6190

Other practice location 6

2501 Parkers Ln
Alexandria, VA 22306-3209
Phone (703) 664-7000

Other practice location 7

8081 Innovation Park Dr
Fairfax, VA 22031-4867
Phone (571) 472-0726

Other practice location 8

3600 Joseph Siewick Dr
Fairfax, VA 22033-1709
Phone (703) 391-3600

Other practice location 9

600 Wilson Creek Rd
Lawrenceburg, IN 47025-2751
Phone (859) 301-2018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, IN, KY3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20200804000514 DC Practitioner - Pathology 3971727686 Reassigns benefits to 1 organization
I20230630000895 IN Practitioner - Pathology 3971727686 Reassigns benefits to 1 organization
I20230825002015 KY Practitioner - Pathology 3971727686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
West Virginia University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Elizabeth Medical Center, IncGroup PAC ID 0648174623, 187 clinicians

Practice addresses (Care Compare)

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 301-4723

600 Wilson Creek Rd
Lawrenceburg, IN 47025-2751
Phone (859) 301-2465

Hospital & facility affiliations

  • St Elizabeth Edgewood Hospital, Edgewood, KY, CCN 180035
  • St Elizabeth Florence Hospital, Florence, KY, CCN 180045

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01090000AINMDAnatomic Pathology & Clinical Pathology Physician
58393KYMDAnatomic Pathology & Clinical Pathology Physician
245525MAMDAnatomic Pathology & Clinical Pathology Physician
0101269191VAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services - Pathology Anatomic Pathology & Clinical Pathology CurrentSince Jun 29, 2020 Accepting new patients
St Elizabeth Medical Center, Inc CurrentSince Jul 10, 2023 Accepting new patients
St Elizabeth Medical Center, Inc CurrentSince Jul 10, 2023 Accepting new patients

Locations

204 Bridgeway St
Aurora, IN 47001
Phone (812) 926-3133

600 Wilson Creek Rd
Lawrenceburg, IN 47025
Phone (812) 532-2700

1500 James Simpson Jr Way
Covington, KY 41011
Phone (859) 655-4353

1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000

238 Barnes Rd
Williamstown, KY 41097
Phone (859) 292-4000

4320 Seminary Rd
Alexandria, VA 22304
Phone (703) 504-3000

2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000

2832 Juniper St
Fairfax, VA 22031
Phone (703) 645-6134

8081 Innovation Park Dr
Fairfax, VA 22031
Phone (571) 472-0606

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

3023 Hamaker Ct
Ste 400
Fairfax, VA 22031
Phone (571) 226-8380

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

Organizations & group practices 3

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 2

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": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1346561008",
    "addresses": [
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            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636324",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636324",
            "telephone_number": "859-301-2018",
            "fax_number": "859-301-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173403",
            "telephone_number": "859-301-2018",
            "fax_number": "859-301-2073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Innovation Dr Ste 3",
            "address_2": "Pathology Residency",
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            "postal_code": "016054306",
            "country_code": "US",
            "telephone_number": "508-334-1000",
            "country_name": "United States",
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        },
        {
            "address_1": "44045 Riverside Pkwy",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "VA",
            "postal_code": "201765101",
            "country_code": "US",
            "telephone_number": "703-858-6000",
            "fax_number": "703-858-6900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3300 Gallows Rd",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220423300",
            "country_code": "US",
            "telephone_number": "703-776-4001",
            "fax_number": "703-776-7113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4320 Seminary Rd",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223041535",
            "country_code": "US",
            "telephone_number": "703-504-3000",
            "fax_number": "703-504-3388",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2832 Juniper St",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220314402",
            "country_code": "US",
            "telephone_number": "703-645-6190",
            "fax_number": "703-645-6136",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2501 Parkers Ln",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223063209",
            "country_code": "US",
            "telephone_number": "703-664-7000",
            "fax_number": "703-664-7666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8081 Innovation Park Dr",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220314867",
            "country_code": "US",
            "telephone_number": "571-472-0726",
            "fax_number": "571-472-0711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3600 Joseph Siewick Dr",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220331709",
            "country_code": "US",
            "telephone_number": "703-391-3600",
            "fax_number": "703-391-3414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 Wilson Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Lawrenceburg",
            "state": "IN",
            "postal_code": "470252751",
            "country_code": "US",
            "telephone_number": "859-301-2018",
            "fax_number": "859-301-2073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEIDY",
        "first_name": "JENNIFER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-17",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": "01090000A",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "VA",
            "license": "0101269191",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MA",
            "license": "245525",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KY",
            "license": "58393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.