Active NPI
Stephen A Leedy, MD
- Family Medicine Physician
- Lakeland, FL
National Provider Identifier
1558314716
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective May 20, 2025.
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME 83980
- Practice address
- 115 S Missouri Ave
Suite 500
Lakeland, FL 33815-4600 - Phone
- (863) 682-0027
- NPI assigned
- May 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME 83980 | FL | Primary |
Addresses
Primary practice location
115 S Missouri Ave
Suite 500
Lakeland, FL 33815-4600
Mailing address
115 S Missouri Ave
Suite 500
Lakeland, FL 33815-4600
Phone (863) 682-0027
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ME 83980 | Other | FL | MEDICAL LICENSE |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 83980 | FL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268697600000",
"number": "1558314716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 S MISSOURI AVE",
"address_2": "SUITE 500",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338154600",
"telephone_number": "863-682-0027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 S MISSOURI AVE",
"address_2": "SUITE 500",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338154600",
"telephone_number": "863-682-0027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEEDY",
"first_name": "STEPHEN",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-18",
"last_updated": "2010-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME 83980",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "ME 83980",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.