Individual provider Active NPI

Jody Leonard, CRNP

  • Primary Care Nurse Practitioner
  • Annapolis, MD
National Provider Identifier
1679041123
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
R194792 Issued in MD
Practice address
2002 Medical Pkwy Ste 670
Annapolis, MD 21401-3277
Phone
(443) 481-1150
NPI assigned
Nov 2, 2018
Last updated
Oct 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X R194792 MD Primary

Addresses

Primary practice location

2002 Medical Pkwy Ste 670
Annapolis, MD 21401-3277

Mailing address

600 Ridgely Ave
Ste 130
Annapolis, MD 21401-1045
Phone (410) 266-8049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190326002544 MD Practitioner - Nurse Practitioner 0446590640 Reassigns benefits to 1 organization
I20211022001480 DC Practitioner - Nurse Practitioner 0446590640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anne Arundel Urology, PAGroup PAC ID 9032178918, 33 clinicians

Practice addresses (Care Compare)

4201 Northview Dr
Suite 201
Bowie, MD 20716-2656
Phone (240) 544-4070

600 Ridgely Ave
Suite 130
Annapolis, MD 21401-1045
Phone (410) 266-8049

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Anne Arundel Urology, PA CurrentSince Jun 29, 2021 Accepting new patients
Anne Arundel Urology, PA CurrentSince Oct 18, 2021 Accepting new patients

Locations

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

600 Ridgely Ave
Ste 130
Annapolis, MD 21401
Phone 4102668049157

600 Ridgely Ave
Ste 222223
Annapolis, MD 21401
Phone (410) 266-0895

4201 Northview Dr
Ste 201
Bowie, MD 20716
Phone (240) 544-4070

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1541116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1679041123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 RIDGELY AVE",
            "address_2": "STE 130",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011045",
            "telephone_number": "410-266-8049",
            "fax_number": "410-266-8054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 MEDICAL PKWY STE 670",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013277",
            "telephone_number": "443-481-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "JODY",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-02",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "R194792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.