Individual provider Active NPI

Leah M Ladley, D.D.S.

  • Periodontics
  • Clermont, FL
National Provider Identifier
1679679559
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
12525 Issued in FL
Practice address
265 Hatteras Ave
Clermont, FL 34711-7456
Phone
(352) 241-8200
NPI assigned
Sep 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 12525 FL Primary

Addresses

Primary practice location

265 Hatteras Ave
Clermont, FL 34711-7456

Mailing address

265 Hatteras Ave
Clermont, FL 34711-7456
Phone (352) 241-8200

Other identifiers 2

IdentifierTypeStateIssuer
64805OtherFLBCBS
970832OtherUNITED CONCORDIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150709001820 FL Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 3870805484

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12525FLMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679679559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 HATTERAS AVE",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347117456",
            "telephone_number": "352-241-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 HATTERAS AVE",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347117456",
            "telephone_number": "352-241-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADLEY",
        "first_name": "LEAH",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "12525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "64805",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "970832",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.