Individual provider Active NPI

Leslie Ellen Clapp, M.D.

  • Pediatrics Physician
  • Raleigh, NC
National Provider Identifier
1366687378
Registry record updated Sep 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2007--01253 Issued in NC
Practice address
4551 New Bern Ave
Suite 160
Raleigh, NC 27610-1551
Phone
(919) 861-7793
Fax
(919) 488-1458
NPI assigned
Dec 4, 2008
Last updated
Sep 20, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2007--01253 NC Primary

Addresses

Primary practice location

4551 New Bern Ave
Suite 160
Raleigh, NC 27610-1551

Mailing address

260 Horizon Dr
Raleigh, NC 27615-4922
Phone (919) 488-0015

Other identifiers 1

IdentifierTypeStateIssuer
00965311MedicaidNY

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2007--01253NCMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1228348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379635200000",
    "number": "1366687378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 HORIZON DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276154922",
            "telephone_number": "919-488-0015",
            "fax_number": "919-277-0066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4551 NEW BERN AVE",
            "address_2": "SUITE 160",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101551",
            "telephone_number": "919-861-7793",
            "fax_number": "919-488-1458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAPP",
        "first_name": "LESLIE",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-04",
        "last_updated": "2013-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2007--01253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00965311",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.