Individual provider Active NPI

Leesah Workman Bragg, RN

  • Hospice Registered Nurse
  • Statesville, NC
National Provider Identifier
1417889163
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice Registered NurseTaxonomy code 163WH1000X
License
205026 Issued in NC
Practice address
811 Ferndale Dr
Statesville, NC 28677-3124
Phone
(704) 500-9301
NPI assigned
May 29, 2026
Last updated
May 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice Registered Nurse 163WH1000X 205026 NC Primary

Addresses

Primary practice location

811 Ferndale Dr
Statesville, NC 28677-3124

Mailing address

811 Ferndale Dr
Statesville, NC 28677-3124
Phone (704) 500-9301

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
205026NCMDHospice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1780012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1417889163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 FERNDALE DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773124",
            "telephone_number": "704-500-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 FERNDALE DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773124",
            "telephone_number": "704-500-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAGG",
        "first_name": "LEESAH",
        "middle_name": "WORKMAN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-29",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "NC",
            "license": "205026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; 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.