Individual provider Active NPI

Jennifer Riley McLeland, M.D.

  • Obstetrics & Gynecology Physician
  • Houston, TX
National Provider Identifier
1619220134
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
Q3552 Issued in TX
Practice address
12828 Willow Centre Dr Ste D
Houston, TX 77066-3043
Phone
(817) 733-5245
NPI assigned
Oct 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD210012293 DC
Obstetrics & Gynecology Physician 207V00000X 0101278931 VA
Obstetrics & Gynecology Physician 207V00000X D97975 MD
Obstetrics & Gynecology Physician 207V00000X 338644 LA
Obstetrics & Gynecology Physician 207V00000X Q3552 TX Primary

Addresses

Primary practice location

12828 Willow Centre Dr Ste D
Houston, TX 77066-3043

Mailing address

12828 Willow Centre Dr Ste D
Houston, TX 77066-3043
Phone (646) 895-3946

Other practice location 1

1250 8th Ave Ste 440
Fort Worth, TX 76104-4144
Phone (817) 502-8484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240207000655 DC Practitioner - Obstetrics/Gynecology 4183924707 Reassigns benefits to 1 organization
I20240213001047 VA Practitioner - Obstetrics/Gynecology 4183924707 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
338644LAMDObstetrics & Gynecology Physician
D97975MDMDObstetrics & Gynecology Physician
0101278931VAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Jan 22, 2024 Accepting new patients
Privia Medical Group, LLC Obstetrics & Gynecology CurrentSince Jan 22, 2024 Accepting new patients

Locations

4910 Massachusetts Ave NW
Ste 114
Washington, DC 20016
Phone (202) 244-0812

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

8644 Sudley Rd
#220
Manassas, VA 20110

Interoperability endpoints

  • Direct secure messaging: jennifer.mcleland@581151983075332.direct.elationemr.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1350864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1619220134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12828 WILLOW CENTRE DR STE D",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770663043",
            "telephone_number": "646-895-3946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12828 WILLOW CENTRE DR STE D",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770663043",
            "telephone_number": "817-733-5245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 8th Ave Ste 440",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761044144",
            "country_code": "US",
            "telephone_number": "817-502-8484",
            "fax_number": "817-921-2701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCLELAND",
        "first_name": "JENNIFER",
        "middle_name": "RILEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-22",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "DC",
            "license": "MD210012293",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101278931",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MD",
            "license": "D97975",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "LA",
            "license": "338644",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "Q3552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.