Individual provider Active NPI

Carol Leader, DO

  • Psychiatry Physician
  • Lansing, MI
National Provider Identifier
1659337301
Registry record updated Sep 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
5101013105 Issued in MI
Practice address
812 E Jolly Rd
Ste 215
Lansing, MI 48910-6818
Phone
(517) 346-8340
Fax
(517) 346-8291
NPI assigned
Apr 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 5101013105 MI Primary

Addresses

Primary practice location

812 E Jolly Rd
Ste 215
Lansing, MI 48910-6818

Mailing address

812 E Jolly Rd
Ste 210
Lansing, MI 48910-6818
Phone (517) 346-8410

Other identifiers 1

IdentifierTypeStateIssuer
114307356MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050405001049 MI Practitioner - Psychiatry 0749237477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Michigan State University College of Osteopathic Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

812 E Jolly Rd
Lansing, MI 48910-6818
Phone (517) 346-8200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101013105MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Mental Health Authority Clinton Eaton Ingham Counties Psychiatry CurrentSince May 1, 2003 Accepting new patients
Community Mental Health Authority Clinton Eaton Ingham Counties Past Accepting new patients

Locations

812 E Jolly Rd
Lansing, MI 48910
Phone (517) 237-7162

812 E Jolly Rd
Ste 210
Lansing, MI 48910
Phone (517) 237-7162

812 E Jolly Rd
Ste 215
Lansing, MI 48910
Phone (517) 346-8300

812 E Jolly Rd
Ste 109
Lansing, MI 48910

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": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283385600000",
    "number": "1659337301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 E JOLLY RD",
            "address_2": "STE 210",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489106818",
            "telephone_number": "517-346-8410",
            "fax_number": "517-346-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 E JOLLY RD",
            "address_2": "STE 215",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489106818",
            "telephone_number": "517-346-8340",
            "fax_number": "517-346-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEADER",
        "first_name": "CAROL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2010-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "5101013105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114307356",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.