Individual provider Active NPI

Laura Groblewski Leahy, DRNP, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Sewell, NJ
National Provider Identifier
1548352875
Registry record updated Feb 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NC08502400 Issued in NJ
Practice address
123 Egg Harbor Rd
Suite 703 Tower Commons
Sewell, NJ 08080-9406
Phone
(856) 556-0860
Fax
(844) 276-7656
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2017

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 26NR08502400 NJ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NC08502400 NJ Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP008666 PA

Addresses

Primary practice location

123 Egg Harbor Rd
Suite 703 Tower Commons
Sewell, NJ 08080-9406

Mailing address

123 Egg Harbor Rd
Suite 703 Tower Commons
Sewell, NJ 08080-9406
Phone (856) 556-0860

Other identifiers 1

IdentifierTypeStateIssuer
6661009MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20150924000214 NJ Order and Referring Only - Nurse Practitioner 3577467042

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NR08502400NJMDRegistered Nurse
26NC08502400NJMDPsychiatric/Mental Health Nurse Practitioner
SP008666PAMDPsychiatric/Mental Health Nurse Practitioner

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486080000000",
    "number": "1548352875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 EGG HARBOR RD",
            "address_2": "SUITE 703 TOWER COMMONS",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080809406",
            "telephone_number": "856-556-0860",
            "fax_number": "844-276-7656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 EGG HARBOR RD",
            "address_2": "SUITE 703 TOWER COMMONS",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080809406",
            "telephone_number": "856-556-0860",
            "fax_number": "844-276-7656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAHY",
        "first_name": "LAURA",
        "middle_name": "GROBLEWSKI",
        "name_prefix": "Dr.",
        "credential": "DRNP, APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2017-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR08502400",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NC08502400",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP008666",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6661009",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sewell, NJ

Sources for this page

Verify at the official NPI Registry.