Individual provider Active NPI

K. Leslie Avery, M.D.

  • Pediatric Critical Care Medicine Physician
  • Gainesville, FL
National Provider Identifier
1508859547
Registry record updated Oct 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
ME115725 Issued in FL
Practice address
Dept of Pediatric Critical Care Shands
1600 SW Archer Rd, Ste. 10-504, Box 100296
Gainesville, FL 32610-0001
Phone
(352) 265-0462
Fax
(352) 265-0443
NPI assigned
Aug 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X ME115725 FL Primary
Pediatric Critical Care Medicine Physician 2080P0203X 11316 NV
Pediatric Critical Care Medicine Physician 2080P0203X A67929 CA
Pediatric Critical Care Medicine Physician 2080P0203X DR.0071896 CO

Addresses

Primary practice location

Dept of Pediatric Critical Care Shands
1600 SW Archer Rd, Ste. 10-504, Box 100296
Gainesville, FL 32610-0001

Mailing address

Dept of Pediatric Critical Care Shands
1600 SW Archer Rd, Ste. 10-504, Box 100296
Gainesville, FL 32610-0001
Phone (352) 265-0462

Other identifiers 1

IdentifierTypeStateIssuer
008799300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A67929CAMDPediatric Critical Care Medicine Physician
DR.0071896COMDPediatric Critical Care Medicine Physician
ME115725FLMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Jul 1, 2013 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jul 1, 2013 Accepting new patients
HCA Healthone LLC Past Accepting new patients

Locations

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

1600 SW Archer Rd
Ste 10504
Gainesville, FL 32610
Phone (352) 265-0462

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

Interoperability endpoints

  • Direct secure messaging: kavery110412@direct.shands.ufl.edu

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696636800000",
    "number": "1508859547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT OF PEDIATRIC CRITICAL CARE SHANDS",
            "address_2": "1600 SW ARCHER RD, STE. 10-504, BOX 100296",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100001",
            "telephone_number": "352-265-0462",
            "fax_number": "352-265-0443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPT OF PEDIATRIC CRITICAL CARE SHANDS",
            "address_2": "1600 SW ARCHER RD, STE. 10-504, BOX 100296",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100001",
            "telephone_number": "352-265-0462",
            "fax_number": "352-265-0443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERY",
        "first_name": "K.",
        "middle_name": "LESLIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-24",
        "last_updated": "2023-10-07",
        "certification_date": "2023-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "FL",
            "license": "ME115725",
            "primary": true
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NV",
            "license": "11316",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CA",
            "license": "A67929",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CO",
            "license": "DR.0071896",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008799300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.