Individual provider Active NPI

Leanne Elizabeth Edwards, MA, LAT, ATC

  • Athletic Trainer
  • Philadelphia, PA
National Provider Identifier
1508829987
Registry record updated Jan 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
RT003859 Issued in PA
Practice address
4050 S 26TH St Ste 140
Philadelphia, PA 19112-1613
Phone
(267) 463-2288
Fax
(215) 468-2789
NPI assigned
Apr 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RT003859 PA Primary

Addresses

Primary practice location

4050 S 26TH St Ste 140
Philadelphia, PA 19112-1613

Mailing address

405 Heritage Dr
Harleysville, PA 19438-3958
Phone (931) 252-2534

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
RT003859PAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388966400000",
    "number": "1508829987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 HERITAGE DR",
            "city": "HARLEYSVILLE",
            "state": "PA",
            "postal_code": "194383958",
            "telephone_number": "931-252-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 S 26TH ST STE 140",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191121613",
            "telephone_number": "267-463-2288",
            "fax_number": "215-468-2789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "LEANNE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "MA, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-07",
        "last_updated": "2014-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT003859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2014; 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.