Individual provider Active NPI

Leslie W Sands, FNP

  • Nurse Practitioner
  • Jackson, TN
National Provider Identifier
1659312106
Registry record updated Aug 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
58105 Issued in TN
Practice address
238 Summar Dr
Jackson, TN 38301-3906
Phone
(731) 935-8200
Fax
(731) 935-8327
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 58105 TN
Nurse Practitioner 363L00000X 58105 TN Primary

Addresses

Primary practice location

238 Summar Dr
Jackson, TN 38301-3906

Mailing address

1804 Highway 45 Byp
Suite 604
Jackson, TN 38305-4436
Phone (731) 660-8759

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20110302000492 TN Practitioner - Nurse Practitioner 0648451211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathways of Tennessee IncGroup PAC ID 6507833613, 42 clinicians

Practice addresses (Care Compare)

223 S Court St
Tiptonville, TN 38079-1305
Phone (731) 253-7780

238 Summar Dr
Jackson, TN 38301-3906
Phone (731) 541-8270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
58105TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways of Tennessee, Inc. CurrentSince Jul 1, 2000 Accepting new patients

Locations

1120 Tammbell St
Brownsville, TN 38012
Phone (731) 541-8344

1720 Woodlawn Ave
Dyersburg, TN 38024
Phone (731) 285-1393

33 Directors Row
Ste A
Jackson, TN 38305
Phone (731) 541-7605

1270 Union University Dr
Ste D
Jackson, TN 38305
Phone (731) 265-6450

238 Summar Dr
Jackson, TN 38301
Phone (731) 541-8200

1804 Highway 45 Byp
Ste 216
Jackson, TN 38305
Phone (731) 664-6327

9550 Highway 412 W
Ste B
Lexington, TN 38351
Phone (731) 968-8197

4039 Highland St
Milan, TN 38358
Phone (731) 660-8755

301 Tyson Ave
Paris, TN 38242
Phone (731) 642-1220

223 S Court St
Tiptonville, TN 38079
Phone (731) 253-7780

930 Mount Zion Rd
Union City, TN 38261
Phone (731) 885-9333

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249430400000",
    "number": "1659312106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 HIGHWAY 45 BYP",
            "address_2": "SUITE 604",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383054436",
            "telephone_number": "731-660-8759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 SUMMAR DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013906",
            "telephone_number": "731-935-8200",
            "fax_number": "731-935-8327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDS",
        "first_name": "LESLIE",
        "middle_name": "W",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2009-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "58105",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "58105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.