J. W, Leisy M.D.P.a.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

14574 Issued in KS

Legal business name

J. W, LEISY M.D.P.A.

Practice address

3310 East Douglas #101
Wichita, KS 67208

Phone

(316) 681-2937

Fax

(316) 681-1262

NPI assigned

May 16, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Jerald W Leisy, M.D. P.A.

Title

President

Phone

(316) 681-2937

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348012800000",
    "number": "1437418019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 EAST DOUGLAS #101",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67208",
            "telephone_number": "316-681-2937",
            "fax_number": "316-681-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 EAST DOUGLAS #101",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67208",
            "telephone_number": "316-681-2937",
            "fax_number": "316-681-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. W, LEISY M.D.P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-16",
        "last_updated": "2012-09-19",
        "status": "A",
        "authorized_official_last_name": "LEISY",
        "authorized_official_first_name": "JERALD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "316-681-2937",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D. P.A."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KS",
            "license": "14574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Wichita, KS
• Providers in Wichita, KS by specialty
• Psychiatry Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; 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.