Individual provider Active NPI

John Tyler Leopard

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1639831241
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-12034 Issued in NC
Practice address
6320 Owenby CT
Charlotte, NC 28270-5962
Phone
(704) 644-9459
NPI assigned
Oct 11, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-12034 NC Primary

Addresses

Primary practice location

6320 Owenby CT
Charlotte, NC 28270-5962

Mailing address

6320 Owenby CT
Charlotte, NC 28270-5962
Phone (704) 644-9459

Other practice location 1

1830 Fordham Blvd Ste 100
Chapel Hill, NC 27514-2301
Phone (919) 364-3312

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jleopard953635@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20220509002457 NC Practitioner - Physician Assistant 9537546759 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

401 A N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

401 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

417 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-8080

606 E 12TH St
Washington, NC 27889-3409
Phone (252) 974-9460

608 E 12TH St
Vidant Multispecialty Clinic Washiington
Washington, NC 27889-3409
Phone (252) 974-7500

628 E 12TH St
Vidant Beaufort Hospitalists
Washington, NC 27889-3409
Phone (252) 975-4178

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Dec 20, 2022 Accepting new patients

Locations

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

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.

Hospital & facility affiliations 2

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": "1633910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1639831241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6320 OWENBY CT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282705962",
            "telephone_number": "704-644-9459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6320 OWENBY CT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282705962",
            "telephone_number": "704-644-9459"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1830 Fordham Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275142301",
            "country_code": "US",
            "telephone_number": "919-364-3312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEOPARD",
        "first_name": "JOHN",
        "middle_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-11",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jleopard953635@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1830 Fordham Blvd Ste 100",
            "city": "Chapel Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275142301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.