Active NPI
Leigh Harless, CCC-A
- Audiologist
- Southfield, MI
National Provider Identifier
1366846552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 1601000691
- Practice address
- 2000 Town Center, Ste 1900
Primesource of Michigan LLC
Southfield, MI 48075-1135 - Phone
- (800) 317-0711
- NPI assigned
- Oct 16, 2014
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 1601000691 | MI | Primary |
Addresses
Primary practice location
2000 Town Center, Ste 1900
Primesource of Michigan LLC
Southfield, MI 48075-1135
Mailing address
2100 E Lake Cook Rd Ste 1100
Primesource Healthcare Systems, Inc
Buffalo Grove, IL 60089-1815
Phone (847) 267-8200
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1601000691 | MI | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413417600000",
"number": "1366846552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 E LAKE COOK RD STE 1100",
"address_2": "PRIMESOURCE HEALTHCARE SYSTEMS, INC",
"city": "BUFFALO GROVE",
"state": "IL",
"postal_code": "600891815",
"telephone_number": "847-267-8200",
"fax_number": "877-821-6402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 TOWN CENTER, STE 1900",
"address_2": "PRIMESOURCE OF MICHIGAN LLC",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480751135",
"telephone_number": "800-317-0711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARLESS",
"first_name": "LEIGH",
"name_prefix": "Mrs.",
"credential": "CCC-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-16",
"last_updated": "2014-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MI",
"license": "1601000691",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.