Active NPI
Leicester Medical Clinic PC
- Family Medicine Physician
- Asheville, NC
National Provider Identifier
1649399528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | NC | Primary | |
| Family Medicine Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89129H0 | Medicaid | NC |
National Provider Directory
National Provider DirectoryLocations
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.