Individual provider Active NPI

James Wendell Leach, M.D.

  • Addiction Medicine (Family Medicine) Physician
  • Loudon, TN
National Provider Identifier
1497835334
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
9419 Issued in TN
Practice address
810 Mulberry St
Loudon, TN 37774-1309
Phone
(865) 657-9303
Fax
(865) 657-9404
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD9419 TN
Obstetrics & Gynecology Physician 207V00000X 9419 TN
Addiction Medicine (Family Medicine) Physician 207QA0401X 9419 TN Primary

Addresses

Primary practice location

810 Mulberry St
Loudon, TN 37774-1309

Mailing address

842 Hatcher LN
Columbia, TN 38401-3528
Phone (931) 388-5104

Other practice location 1

1149 Nashville Hwy
Lewisburg, TN 37091-2236
Phone (931) 422-2444

Other identifiers 3

IdentifierTypeStateIssuer
2009778OtherTNBCBS
10067723MedicaidTN
Q009993MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120209000794 TN Practitioner - Obstetrics/Gynecology 9537326046 Practice locations: Columbia, TN

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9419TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rbi Wellness Center, LLC CurrentSince Jan 28, 2024 Accepting new patients
Sweet Dreams Anesthesia Inc Past Accepting new patients
Lewisburg Recovery Center, LLC PastSince Apr 3, 2022 Accepting new patients

Locations

810 Mulberry St
Loudon, TN 37774
Phone (865) 657-9303

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1497835334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 HATCHER LN",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384013528",
            "telephone_number": "931-388-5104",
            "fax_number": "931-840-6266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 MULBERRY ST",
            "city": "LOUDON",
            "state": "TN",
            "postal_code": "377741309",
            "telephone_number": "865-657-9303",
            "fax_number": "865-657-9404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1149 Nashville Hwy",
            "address_purpose": "LOCATION",
            "city": "Lewisburg",
            "state": "TN",
            "postal_code": "370912236",
            "country_code": "US",
            "telephone_number": "931-422-2444",
            "fax_number": "931-422-2445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEACH",
        "first_name": "JAMES",
        "middle_name": "WENDELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD9419",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "9419",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "TN",
            "license": "9419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2009778",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10067723",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q009993",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loudon, TN

Sources for this page

Verify at the official NPI Registry.