Individual provider Active NPI

Leoncia Kaye Gillespie, MSN, WHNP-BC

  • Women's Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1508642158
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
297308 Issued in AZ
Practice address
303 E Baseline Rd
Phoenix, AZ 85042-6530
Phone
(602) 243-7277
NPI assigned
Sep 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 183901 CT
Registered Nurse 163W00000X 352483 NC
Women's Health Nurse Practitioner 363LW0102X 297308 AZ Primary

Addresses

Primary practice location

303 E Baseline Rd
Phoenix, AZ 85042-6530

Mailing address

303 E Baseline Rd
Phoenix, AZ 85042-6530

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231206002842 AZ Practitioner - Nurse Practitioner 4789033481 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain Park Health CenterGroup PAC ID 8325949647, 117 clinicians

Practice addresses (Care Compare)

303 E Baseline Rd
Phoenix, AZ 85042-6530
Phone (602) 243-7277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
183901CTMDRegistered Nurse
352483NCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Park Health Center Current Accepting new patients
Mountain Park Health Center CurrentSince Nov 13, 2023 Accepting new patients
Mountain Park Health Center CurrentSince Nov 13, 2023 Accepting new patients
Mountain Park Health Center - Dental Past Accepting new patients

Locations

635 E Baseline Rd
Phoenix, AZ 85042

303 E Baseline Rd
Phoenix, AZ 85042
Phone (602) 277-6181

3003 N Central Ave
Ste 1600
Phoenix, AZ 85012
Phone (602) 323-3492

Interoperability endpoints

  • Direct secure messaging: leoncia.gillespie@mphc.eclinicaldirectplus.com

Organizations & group practices 4

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": "1694044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1508642158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E BASELINE RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850426530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E BASELINE RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850426530",
            "telephone_number": "602-243-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLESPIE",
        "first_name": "LEONCIA",
        "middle_name": "KAYE",
        "credential": "MSN, WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-07",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "183901",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "352483",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AZ",
            "license": "297308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.