Individual provider Active NPI

Leah Rosser Raettig, FNP

  • Nurse Practitioner
  • New Bern, NC
National Provider Identifier
1417305780
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5011867 Issued in NC
Practice address
738 Newman Rd
New Bern, NC 28562-5238
Phone
(252) 634-2676
Fax
(252) 637-4479
NPI assigned
May 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0001230204 VA
Nurse Practitioner 363L00000X 5011867 NC Primary

Addresses

Primary practice location

738 Newman Rd
New Bern, NC 28562-5238

Mailing address

PO Box 68
Pollocksville, NC 28573-0068
Phone (252) 634-2676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20191008000723 NC Practitioner - Nurse Practitioner 2769778356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, shared by 5 NPIs, 540 clinicians
Carolinaeast PhysiciansGroup PAC ID 0143378117, 203 clinicians

Practice addresses (Care Compare)

2303 Wellington Dr SW
Wilson, NC 27893-8620
Phone (252) 243-6818

738 Newman Rd
New Bern, NC 28562-5238
Phone (252) 634-2676

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
72.61 of 100Reported as group
Quality
57.39
Promoting interoperability
68
Improvement activities
40
Cost
77.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinaeast Physicians CurrentSince Oct 1, 2022 Accepting new patients
Carolinaeast Physicians CurrentSince Oct 1, 2022 Accepting new patients
Carolinaeast Physicians Current Accepting new patients
Carolinaeast Physicians Past Accepting new patients

Locations

532 Webb Blvd
Havelock, NC 28532
Phone (252) 447-7088

201 Williamsburg Pkwy
Jacksonville, NC 28546
Phone (252) 634-2626

738 Newman Rd
New Bern, NC 28562
Phone (252) 633-0361

137 Medical Ln
Pollocksville, NC 28573
Phone (252) 633-1010

Interoperability endpoints

  • Direct secure messaging: lraettig19445@carolinaeastmc.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1464307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1417305780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 68",
            "city": "POLLOCKSVILLE",
            "state": "NC",
            "postal_code": "285730068",
            "telephone_number": "252-634-2676",
            "fax_number": "252-637-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "738 NEWMAN RD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625238",
            "telephone_number": "252-634-2676",
            "fax_number": "252-637-4479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAETTIG",
        "first_name": "LEAH",
        "middle_name": "ROSSER",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-27",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0001230204",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5011867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

Verify at the official NPI Registry.