Individual provider Active NPI

Kristine Marie Leo, NP

  • Family Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1366487605
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
17925 Issued in SC
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

Updated by the provider on Feb 13, 2019

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 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

OrganizationSpecialtyStatusNew patients
Extended Medical Services, PLLC CurrentSince Feb 15, 2008 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

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.