Evan James Leonard, P.A.-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9108342 Issued in FL

Practice address

851042 US Highway 17
Yulee, FL 32097-2845

Phone

(904) 633-0670

NPI assigned

Oct 15, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. 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

Physician Assistant

Practice roles

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.

• University of Florida Jacksonville Physicians, Inc.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1144276452
  NPD (past)
• University of Florida Jacksonville Physicians, Inc.

  • Family Medicine Physician
  • Yulee, FL
  • NPI 1518126168
  NPD (past)

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

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1558765875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 MONUMENT RD",
            "address_2": "APARTMENT 1512",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322256492",
            "telephone_number": "727-253-7041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851042 US HIGHWAY 17",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320972845",
            "telephone_number": "904-633-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "EVAN",
        "middle_name": "JAMES",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-15",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9108342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003173206A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015527600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Lawrence
• Allexia Hope Lebarron
• Thomas Lee, MS RD
• Legacy Therapeutic Solutions LLC
• Emily Lenhart, OTR/L
• Let It Shine Therapy LLC
• Sharon Renee Lettsome
• Journey Cerese Leyva
• Life on Purpose Counseling and Coaching Services, LLC
• Eli Steven Loch, D.O.

• Medical Physician Assistant in Yulee, FL
• Providers in Yulee, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; 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.