Active NPI
Kelly Ann Leopold
- Neonatal Nurse Practitioner
- Dayton, OH
National Provider Identifier
1447879895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal Nurse Practitioner
- License
- APRN.CNP.0027080
- Practice address
- 1 Wyoming St
Dayton, OH 45409-2722 - Phone
- (937) 208-8000
- NPI assigned
- Apr 15, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Neonatal Nurse Practitioner | 363LN0000X | APRN.CNP.0027080 | OH | Primary |
Addresses
Primary practice location
1 Wyoming St
Dayton, OH 45409-2722
Mailing address
8264 Lytle Trails Rd
Waynesville, OH 45068-9255
Phone (937) 673-1232
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201014002897 | OH | Order and Referring Only - Nurse Practitioner | 0042119794 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN.CNP.0027080 | OH | MD | Neonatal Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597708800000",
"number": "1447879895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8264 LYTLE TRAILS RD",
"city": "WAYNESVILLE",
"state": "OH",
"postal_code": "450689255",
"telephone_number": "937-673-1232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 WYOMING ST",
"city": "DAYTON",
"state": "OH",
"postal_code": "454092722",
"telephone_number": "937-208-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEOPOLD",
"first_name": "KELLY",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-15",
"last_updated": "2020-08-18",
"certification_date": "2020-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "OH",
"license": "APRN.CNP.0027080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.