Lesley D Looper, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

TL1702 Issued in SC

Practice address

309 W Butler Rd
Mauldin, SC 29662-2531

Phone

(864) 297-1575

Fax

(864) 297-6256

NPI assigned

Nov 2, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1320192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321315200000",
    "number": "1386920502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 ARDEN ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296071704",
            "telephone_number": "864-784-3442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 W BUTLER RD",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296622531",
            "telephone_number": "864-297-1575",
            "fax_number": "864-297-6256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOOPER",
        "first_name": "LESLEY",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-02",
        "last_updated": "2011-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "TL1702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in Mauldin, SC
• Providers in Mauldin, SC by specialty
• Medical Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; 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.