Active NPI
Leah Melissa Fleetwood, P.A.
- Physician Assistant
- Bloomington, IN
National Provider Identifier
1467689877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10001085A
- Practice address
- 601 W 2ND St
Bloomington, IN 47403-2317 - Phone
- (812) 353-9515
- Fax
- (812) 353-9275
- NPI assigned
- Jun 12, 2009
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10001085A | IN | Primary |
Addresses
Primary practice location
601 W 2ND St
Bloomington, IN 47403-2317
Mailing address
PO Box 1329
Bloomington, IN 47402-1329
Other practice location 1
2400 17th St
Columbus, IN 47201-5351
Phone (812) 379-4441
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lfleetwood20461@edirect.crh.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10001085A | IN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indiana University Health Southern Indiana Physicians LLC | Current | Accepting new patients | |
| Indiana University Health Southern Indiana Physicians, LLC | Physician Assistant | Current | Accepting new patients |
Locations
727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450
601 W 2nd St
Bloomington, IN 47403
Phone (812) 353-5252
Interoperability endpoints
- lfleetwood20461@edirect.crh.org
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.
-
- Multi-Specialty Clinic/Center
- Bloomington, IN
- NPI 1013953983
Physician Assistant
-
- Emergency Medicine Physician
- Columbus, IN
- NPI 1912951062
-
- Durable Medical Equipment & Medical Supplies
- Bloomington, IN
- NPI 1063179844
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604361600000",
"number": "1467689877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1329",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474021329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 W 2ND ST",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474032317",
"telephone_number": "812-353-9515",
"fax_number": "812-353-9275"
}
],
"practiceLocations": [
{
"address_1": "2400 17th St",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "IN",
"postal_code": "472015351",
"country_code": "US",
"telephone_number": "812-379-4441",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FLEETWOOD",
"first_name": "LEAH",
"middle_name": "MELISSA",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-12",
"last_updated": "2020-11-03",
"certification_date": "2020-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IN",
"license": "10001085A",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lfleetwood20461@edirect.crh.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2400 17th St",
"city": "Columbus",
"state": "IN",
"country_code": "US",
"postal_code": "472015351",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.