Organization Active NPI

Leicester Medical Clinic PC

  • Family Medicine Physician
  • Asheville, NC
National Provider Identifier
1649399528
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LEICESTER MEDICAL CLINIC PC
Practice address
304 New Leicester Hwy
Suite a
Asheville, NC 28806
Phone
(828) 255-4723
Fax
(828) 255-4726
NPI assigned
Mar 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Susan Wynn Peterson, MD
Title
President
Phone
(828) 255-4723

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X NC Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X NC

Addresses

Primary practice location

304 New Leicester Hwy
Suite a
Asheville, NC 28806

Mailing address

304 New Leicester Hwy
Suite a
Asheville, NC 28806
Phone (828) 255-4723

Other identifiers 1

IdentifierTypeStateIssuer
89129H0MedicaidNC

National Provider Directory

National Provider Directory

Locations

304 New Leicester Hwy
#A
Asheville, NC 28806
Phone (828) 232-8934

304 New Leicester Hwy
Asheville, NC 28806
Phone (828) 232-8934

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649399528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 NEW LEICESTER HWY",
            "address_2": "SUITE A",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "28806",
            "telephone_number": "828-255-4723",
            "fax_number": "828-255-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 NEW LEICESTER HWY",
            "address_2": "SUITE A",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "28806",
            "telephone_number": "828-255-4723",
            "fax_number": "828-255-4726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEICESTER MEDICAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "WYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "828-255-4723",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89129H0",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.