Individual provider Active NPI

Candice S Leach, FNP-C

  • Family Nurse Practitioner
  • Jonesboro, LA
National Provider Identifier
1568844728
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP08298 Issued in LA
Practice address
121 Watts St
Jonesboro, LA 71251-2062
Phone
(318) 259-5080
Fax
(318) 259-5652
NPI assigned
Jun 24, 2015
Last updated
Apr 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP08298 LA Primary

Addresses

Primary practice location

121 Watts St
Jonesboro, LA 71251-2062

Mailing address

121 Watts St
Jonesboro, LA 71251-2062
Phone (318) 259-5080

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cleach@jph.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150730010551 LA Practitioner - Nurse Practitioner 9335453778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Parish HospitalGroup PAC ID 9335048081, 10 clinicians

Practice addresses (Care Compare)

165 Beech Springs Rd
Jonesboro, LA 71251-2013
Phone 3182594435223

165 Beech Springs Rd
Jonesboro, LA 71251-2059

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Parish Hospital CurrentSince Jul 1, 2017 Accepting new patients
Jackson Parish Hospital Past Accepting new patients
Jackson Parish Hospital Past Accepting new patients

Locations

804 Chatham Ave
Chatham, LA 71226
Phone (318) 249-3200

107 Watts St
Jonesboro, LA 71251
Phone (318) 395-2121

121 Watts St
Jonesboro, LA 71251
Phone (318) 395-1159

121 Watts St
Ste A
Jonesboro, LA 71251
Phone (318) 259-5636

121 Watts St
Ste F
Jonesboro, LA 71251
Phone (318) 395-3051

165 Beech Springs Rd
Jonesboro, LA 71251
Phone (318) 259-4435

Interoperability endpoints

  • Direct secure messaging: cleach@jph.cernerdirect.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/21ed112e-ec5e-43b1-8ddc-cd3753841e6e/

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1568844728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 WATTS ST",
            "city": "JONESBORO",
            "state": "LA",
            "postal_code": "712512062",
            "telephone_number": "318-259-5080",
            "fax_number": "318-259-5652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 WATTS ST",
            "city": "JONESBORO",
            "state": "LA",
            "postal_code": "712512062",
            "telephone_number": "318-259-5080",
            "fax_number": "318-259-5652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEACH",
        "first_name": "CANDICE",
        "middle_name": "S",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-24",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP08298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cleach@jph.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "121 Watts St",
            "city": "Jonesboro",
            "state": "LA",
            "country_code": "US",
            "postal_code": "712512062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jonesboro, LA

Sources for this page

Verify at the official NPI Registry.