Individual provider Active NPI

Leslie Gail Weisenberger

  • Registered Nurse
  • Oakley, MI
National Provider Identifier
1396348678
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704257368 Issued in MI
Practice address
14642 W Ridge Rd
Oakley, MI 48649-9786
Phone
(989) 494-3012
NPI assigned
Nov 18, 2020
Last updated
Nov 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704257368 MI
Registered Nurse 163W00000X 4704257368 MI Primary

Addresses

Primary practice location

14642 W Ridge Rd
Oakley, MI 48649-9786

Mailing address

14642 W Ridge Rd
Oakley, MI 48649-9786
Phone (989) 494-3012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220112000287 MI Practitioner - Nurse Practitioner 5698167245 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704257368MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Owosso Medical Associates PC CurrentSince Dec 2, 2021 Accepting new patients
Memorial Hospital Family Current Accepting new patients
Memorial Hospital Family CurrentSince Jan 1, 2022 Accepting new patients
Memorial Hospital CurrentSince Jan 1, 2022 Accepting new patients

Locations

9000 Peet Rd
Chesaning, MI 48616
Phone (989) 720-2273

1637 W Main St
Owosso, MI 48867
Phone (989) 725-2299

300 Health Park Dr
Ste 304
Owosso, MI 48867
Phone (989) 729-4222

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1396348678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14642 W RIDGE RD",
            "city": "OAKLEY",
            "state": "MI",
            "postal_code": "486499786",
            "telephone_number": "989-494-3012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14642 W RIDGE RD",
            "city": "OAKLEY",
            "state": "MI",
            "postal_code": "486499786",
            "telephone_number": "989-494-3012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISENBERGER",
        "first_name": "LESLIE",
        "middle_name": "GAIL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-18",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704257368",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704257368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakley, MI

Sources for this page

Verify at the official NPI Registry.