Active NPI
Kristine Marie Leo, NP
- Family Nurse Practitioner
- Greenville, SC
National Provider Identifier
1366487605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 17925
- Practice address
- 1809 Wade Hampton Blvd Ste 120
Greenville, SC 29609-4050 - Phone
- (864) 522-5000
- Fax
- (864) 241-9275
- NPI assigned
- Jun 19, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 17925 | SC | Primary |
Addresses
Primary practice location
1809 Wade Hampton Blvd Ste 120
Greenville, SC 29609-4050
Mailing address
1 Independence PT Ste 212
Greenville, SC 29615-4536
Phone (864) 797-6308
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)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Extended Medical Services, PLLC | Current | Accepting new patients |
Locations
1024 Hilton Parma Rd
Hilton, NY 14468
Phone (585) 392-4114
2116 E Henrietta Rd
Rochester, NY 14623
Phone (585) 204-0551
811 Ridge Rd
#101
Webster, NY 14580
Phone (585) 671-4660
Interoperability endpoints
- kleo4981@direct.ghs.myhfn.org
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.
-
- Urgent Care Clinic/Center
- Hilton, NY
- NPI 1053405241
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550016000000",
"number": "1366487605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 INDEPENDENCE PT STE 212",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296154536",
"telephone_number": "864-797-6308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1809 WADE HAMPTON BLVD STE 120",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296094050",
"telephone_number": "864-522-5000",
"fax_number": "864-241-9275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEO",
"first_name": "KRISTINE",
"middle_name": "MARIE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-19",
"last_updated": "2019-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "SC",
"license": "17925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.