Active NPI
Leslie C Duis, MD
- Family Medicine Physician
- Muncie, IN
National Provider Identifier
1477542074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01053033A
- Practice address
- 5116 W Preakness CT
Muncie, IN 47304-5327 - Phone
- (765) 284-1115
- Fax
- (765) 284-1115
- NPI assigned
- Oct 17, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01053033A | IN | Primary |
Addresses
Primary practice location
5116 W Preakness CT
Muncie, IN 47304-5327
Mailing address
5116 W Preakness CT
Muncie, IN 47304-5327
Phone (765) 284-1115
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01053033A | IN | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477542074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5116 W PREAKNESS CT",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473045327",
"telephone_number": "765-284-1115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5116 W PREAKNESS CT",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473045327",
"telephone_number": "765-284-1115",
"fax_number": "765-284-1115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUIS",
"first_name": "LESLIE",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01053033A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Muncie, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.