NPIMap

Individual provider Active NPI

Lawrence J Leader, DO

  • Cardiovascular Disease Physician
  • Hattiesburg, MS
National Provider Identifier
1508970211
Registry record updated Jul 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
14515 Issued in MS
Practice address
415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone
(601) 268-5800
Fax
(601) 261-3530
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 38

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.

View all 38

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Nova Southeastern College of Osteo Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Walthall General Hospital 7 clinicians
Forrest County General Hospital 107 clinicians
Hattiesburg Clinic PA 525 clinicians
FGH Physician Billing 27 clinicians

Practice addresses (Care Compare)

100 Hospital Dr
Tylertown, MS 39667-2022
Phone (601) 876-2122

1560 Sumrall Rd
Columbia, MS 39429-2654
Phone (601) 736-6303

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000

6051 U S Hwy 49
Hattiesburg, MS 39401-7200
Phone (601) 288-2474

Hospital & facility affiliations

  • Forrest General Hospital Hospital, Hattiesburg, MS, CCN 250078
  • Highland Community Hospital Hospital, Picayune, MS, CCN 250117
  • Marion General Hospital Hospital, Columbia, MS, CCN 250085
  • South Central Reg Med Ctr Hospital, Laurel, MS, CCN 250058
  • Walthall County General Hospital Cah Hospital, Tylertown, MS, CCN 251324

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050616000373 MS Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8022088954 Reassigns benefits to 5 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
FGH Physician Billing Cardiovascular Disease CurrentSince Aug 4, 2007 Accepting new patients
Magee Benevolent Association Current Accepting new patients
Walthall General Hospital CurrentSince Sep 25, 2011 Accepting new patients
Hattiesburg Clinic PA CurrentSince Apr 1, 2005 Accepting new patients
Walthall General Hospital CurrentSince Sep 25, 2011 Accepting new patients
Magee Benevolent Association CurrentSince Jul 22, 2021 Accepting new patients
Forrest County General Hospital CurrentSince Sep 1, 2015 Accepting new patients
Hattiesburg Clinic, PA CurrentSince Apr 1, 2005 Accepting new patients
Forrest County General Hospital CurrentSince Sep 1, 2015 Accepting new patients
Magee Benevolent Association CurrentSince Jul 22, 2021 Accepting new patients
Forrest County General Hospital Current Accepting new patients
State of Mississippi - University of Mississippi Medical Center Past Accepting new patients
Stone County Hospital, Inc Past Accepting new patients
Hattiesburg Clinic, PA Past Accepting new patients

Locations

502 Broad St
Columbia, MS 39429
Phone (601) 736-8282

1560 Sumrall Rd
Columbia, MS 39429
Phone (601) 736-6303

415 S 28th Ave
Fl 3
Hattiesburg, MS 39401
Phone (601) 268-1734

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690

300 SE 3rd Ave
Magee, MS 39111
Phone (601) 849-5070

801 Goodyear Blvd
Picayune, MS 39466
Phone (601) 749-0688

100 Hospital Dr
Tylertown, MS 39667
Phone (601) 876-0455

Interoperability endpoints

  • Direct secure messaging: lleader1858@directpatientrecord.com

NPPES NPI Registry

Updated by the provider on Jul 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 14515 MS Primary

Addresses

Primary practice location

415 S 28TH Ave
Hattiesburg, MS 39401-7246

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 296-3399

Other identifiers 3

IdentifierTypeStateIssuer
00115279MedicaidMS
640507572YROtherMSAMERICAN ADMIN GROUP
1779539MedicaidLA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lleader1858@directpatientrecord.com Health Information Exchange (HIE)

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1508970211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-296-3399",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-268-5800",
            "fax_number": "601-261-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEADER",
        "first_name": "LAWRENCE",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "14515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00115279",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ADMIN GROUP",
            "identifier": "640507572YR",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1779539",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lleader1858@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "415 S 28th Ave",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394017246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.