Active NPI
Gary L Leno, P.M.H.N.P.
- Adult Psychiatric/Mental Health Clinical Nurse Specialist
- Walla Walla, WA
National Provider Identifier
1457301491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Psychiatric/Mental Health Clinical Nurse Specialist
- License
- AP60426528
- 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, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457301491 | Medicaid | WA | |
| 223347 | Medicaid | OR |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 200350053NP PMHNP-PP | OR | MD | Psychiatric/Mental Health Registered Nurse |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Psychiatric/Mental Health Nurse Practitioner
- Pendleton, OR
- NPI 1316210248
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.