Leisa Joan Roan, NP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

214754 Issued in LA

Practice address

2539 Viking Dr Ste 100
Bossier City, LA 71111-1611

Phone

(318) 747-8105

Fax

(318) 747-8150

NPI assigned

Sep 17, 2020

Last updated

Apr 8, 2021By the provider in NPPES

Sex

Female

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 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in LA

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bossier Family Medicine, LLCGroup PAC ID 1850318122, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IGAJAA

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.

• Bossier Family Medicine, LLC

  dba Bossier Family Medicine

  • Family Medicine Physician
  • Bossier City, LA
  • NPI 1003032236
  Medicare reassignment Care Compare group NPD
• Bossier Family Medicine, LLC

  dba First Care Bossier

  • Urgent Care Clinic/Center
  • Bossier City, LA
  • NPI 1629577895
  NPD

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

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1568078392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2539 VIKING DR STE 101",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112165",
            "telephone_number": "318-747-8100",
            "fax_number": "318-747-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2539 VIKING DR STE 100",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711111611",
            "telephone_number": "318-747-8105",
            "fax_number": "318-747-8150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROAN",
        "first_name": "LEISA",
        "middle_name": "JOAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-17",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "214754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023205",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ecw",
            "affiliation": "N",
            "address_1": "2539 Viking Dr Ste 100",
            "city": "Bossier City",
            "state": "LA",
            "country_code": "US",
            "postal_code": "711111611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• River City Physical Therapy, Inc.
• Taylor Rivers
• Riverview Care Center, LLC (Riverview Care Center)
• Road2Wellness, LLC
• Heather Roan
• Jasmine Roberson
• Michael Roberts, BCBA; LBA
• Priscilla Carol Roberts, RN
• Summer Leigh Robin, APRN,FNP
• Dasia Robinson

• Family Medicine Physician in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.