Individual provider Active NPI

Gary L Leno, P.M.H.N.P.

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Walla Walla, WA
National Provider Identifier
1457301491
Registry record updated Feb 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
AP60426528 Issued in WA
Practice address
1520 Kelly PL
Suite 234
Walla Walla, WA 99362-8607
Phone
(509) 522-4000
Fax
(509) 522-5290
NPI assigned
May 11, 2006
Last updated
Feb 24, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X AP60426528 WA Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X 200350053NP PMHNP-PP OR

Addresses

Primary practice location

1520 Kelly PL
Suite 234
Walla Walla, WA 99362-8607

Mailing address

402 S 4TH Ave
Yakima, WA 98902-3546
Phone (509) 575-4084

Other identifiers 2

IdentifierTypeStateIssuer
1457301491MedicaidWA
223347MedicaidOR

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
200350053NP PMHNP-PPORMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
3-D Healthcare Services P.C. 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424736000000",
    "number": "1457301491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 S 4TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023546",
            "telephone_number": "509-575-4084",
            "fax_number": "509-225-6313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 KELLY PL",
            "address_2": "SUITE 234",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993628607",
            "telephone_number": "509-522-4000",
            "fax_number": "509-522-5290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENO",
        "first_name": "GARY",
        "middle_name": "L",
        "credential": "P.M.H.N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2015-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "WA",
            "license": "AP60426528",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OR",
            "license": "200350053NP PMHNP-PP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457301491",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "223347",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walla Walla, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; 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.