Individual provider Active NPI

Leanne Marie Embry, PHD

  • Psychologist
  • San Antonio, TX
National Provider Identifier
1457468449
Registry record updated Mar 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
31709 Issued in TX
Practice address
333 N. Santa Rosa Street, 8TH Floor
Uthscsa, Pediatric Hematology/Oncology
San Antonio, TX 78207
Phone
(210) 704-2987
Fax
(210) 704-2396
NPI assigned
Aug 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 31709 TX Primary

Addresses

Primary practice location

333 N. Santa Rosa Street, 8TH Floor
Uthscsa, Pediatric Hematology/Oncology
San Antonio, TX 78207

Mailing address

333 N. Santa Rosa Street, 8TH Floor
Uthscsa, Pediatric Hematology/Oncology
San Antonio, TX 78207
Phone (210) 704-2987

Other identifiers 1

IdentifierTypeStateIssuer
176142103MedicaidTX

Other names 1

  • Leanne Embry Segovia Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050902000685 TX Practitioner - Clinical Psychologist 9537191135 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
31709TXMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Health Science Center at San Antonio CurrentSince Nov 21, 2010 Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Nov 21, 2010 Accepting new patients
University of Texas Health Science Center at San Antonio Past Accepting new patients

Locations

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

333 N Santa Rosa
Fl 8
San Antonio, TX 78207
Phone (210) 704-2187

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268697600000",
    "number": "1457468449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N. SANTA ROSA STREET, 8TH FLOOR",
            "address_2": "UTHSCSA, PEDIATRIC HEMATOLOGY/ONCOLOGY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78207",
            "telephone_number": "210-704-2987",
            "fax_number": "210-704-2396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N. SANTA ROSA STREET, 8TH FLOOR",
            "address_2": "UTHSCSA, PEDIATRIC HEMATOLOGY/ONCOLOGY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78207",
            "telephone_number": "210-704-2987",
            "fax_number": "210-704-2396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMBRY",
        "first_name": "LEANNE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2010-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "31709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176142103",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEANNE",
            "last_name": "SEGOVIA",
            "middle_name": "EMBRY",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.