Active NPI
Marsha Leake, VICE PRESIDENT
- Adult Day Care Clinic/Center
- Bartlett, TN
National Provider Identifier
1407366362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Day Care Clinic/Center
- Practice address
- 5724 Stage Rd Ste F
Bartlett, TN 38134-4572 - Phone
- (901) 383-0417
- NPI assigned
- Oct 5, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Adult Day Care Clinic/Center | 261QA0600X | Primary |
Addresses
Primary practice location
5724 Stage Rd Ste F
Bartlett, TN 38134-4572
Mailing address
4630 Orange Tulip Dr
Memphis, TN 38135-0749
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000000000000 | Other | INDIVIDUAL |
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)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Senior Enhancement Center | Adult Day Care | Past | Accepting new patients |
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": "1507161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507161600000",
"number": "1407366362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4630 ORANGE TULIP DR",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381350749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5724 STAGE RD STE F",
"city": "BARTLETT",
"state": "TN",
"postal_code": "381344572",
"telephone_number": "901-383-0417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEAKE",
"first_name": "MARSHA",
"credential": "VICE PRESIDENT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-05",
"last_updated": "2017-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "261QA0600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Day Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIVIDUAL",
"identifier": "0000000000000",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Bartlett, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.