Individual provider Active NPI

Dzintra Leblanc, NP

  • Family Nurse Practitioner
  • Brookhaven, GA
National Provider Identifier
1619576931
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
225127 Issued in GA
Practice address
2154 Johnson Ferry Rd NE
Brookhaven, GA 30319-2558
Phone
(404) 948-3019
NPI assigned
Oct 19, 2020
Last updated
Oct 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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 225127 GA Primary

Addresses

Primary practice location

2154 Johnson Ferry Rd NE
Brookhaven, GA 30319-2558

Mailing address

2583 Ballew CT NE
Marietta, GA 30062-4424
Phone (678) 650-4188

Other practice location 1

2583 Ballew Ct NE
Marietta, GA 30062-4424
Phone (678) 650-4188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
225127GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Medical Care Corporation Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dzintra.leblanc.1@28492.direct.athenahealth.com
  • Direct secure messaging: ms_dlebla10@landmarkhealth-direct.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1619576931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2583 BALLEW CT NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300624424",
            "telephone_number": "678-650-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2154 JOHNSON FERRY RD NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303192558",
            "telephone_number": "404-948-3019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2583 Ballew Ct NE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300624424",
            "country_code": "US",
            "telephone_number": "678-650-4188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "DZINTRA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-19",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "225127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, GA

Sources for this page

Verify at the official NPI Registry.