Leslie Smith, ARNP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

9203170 Issued in FL

Practice address

12675 Beach Blvd #101
Jacksonville, FL 32246

Phone

(904) 204-1541

NPI assigned

Dec 18, 2012

Last updated

Jul 21, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Leslie Gillis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Exodus Women's Center, Inc.

  • Obstetrics & Gynecology Physician
  • Lakeland, FL
  • NPI 1336306372
  NPD (past)

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

{
    "created_epoch": "1355788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1487990503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 PALMER TER",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078939",
            "telephone_number": "813-541-8911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12675 BEACH BLVD #101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32246",
            "telephone_number": "904-204-1541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "836 Prudential Dr Ste 1202",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078339",
            "country_code": "US",
            "telephone_number": "904-208-2550",
            "fax_number": "904-346-5410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LESLIE",
        "name_prefix": "Mrs.",
        "credential": "ARNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-18",
        "last_updated": "2021-07-21",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "9203170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "GILLIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lakesha Regina Smith, MD
• Laura V Smith, OTR/L M.O.T.
• Lauren Smith, RBT
• Lauren Smith
• Lauren Tyler Smith, CLD, CPD
• Lindsay Hanke Smith, DPT, ATC
• Lisa J Smith, ARNP
• Logan Smith, PHARMD
• Loren Michelle Smith, MA, BCBA
• Lynn Renee Smith, MPT, ATC

• Adult Health Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; 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.