Active NPI
Caleb Tyler Leach, CRNA
- Anesthesiology Physician
- Flowood, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 901756
- Practice address
- 1030 River Oaks Dr
Flowood, MS 39232-9553 - Phone
- (601) 490-0492
- NPI assigned
- Jan 14, 2022
- Last updated
- Jan 14, 2022
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 901756 | MS | Primary |
Addresses
Primary practice location
1030 River Oaks Dr
Flowood, MS 39232-9553
Mailing address
189 Stone Creek Dr
Madison, MS 39110-5058
Phone (601) 490-0492
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1225 N State St
Ms Baptist Medical Center
Jackson, MS 39202-2064
Phone (601) 317-2802
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesia Consultants PA | Anesthesiology | Current | Accepting new patients |
| Perioperative Services of Mississippi, LLC | Anesthesiology | Current | Accepting new patients |
Locations
350 Crossgates Blvd
Brandon, MS 39042
Phone (601) 824-8500
1030 River Oaks Dr
Jackson, MS 39232
Phone (601) 376-2165
1225 N State St
Jackson, MS 39202
Phone (601) 292-4261
Organizations & group practices 2
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.
-
- Anesthesiology Physician
- Jackson, MS
- NPI 1881123123
-
- Anesthesiology Physician
- Jackson, MS
- NPI 1750300836
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jackson, MS
- NPI 1710909585
-
dba Merit Health Madison
- General Acute Care Hospital
- Canton, MS
- NPI 1194770404
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642118400000",
"number": "1588315238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "189 STONE CREEK DR",
"city": "MADISON",
"state": "MS",
"postal_code": "391105058",
"telephone_number": "601-490-0492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030 RIVER OAKS DR",
"city": "FLOWOOD",
"state": "MS",
"postal_code": "392329553",
"telephone_number": "601-490-0492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEACH",
"first_name": "CALEB",
"middle_name": "TYLER",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-01-14",
"last_updated": "2022-01-14",
"certification_date": "2022-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MS",
"license": "901756",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Flowood, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.