Individual provider Active NPI

Stephen Leblanc, M.D.

  • Allergy & Immunology (Internal Medicine) Physician
  • Meridian, MS
National Provider Identifier
1679837066
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology (Internal Medicine) PhysicianTaxonomy code 207RA0201X
License
23514 Issued in MS
Practice address
3704 Highway 39 N
Meridian, MS 39301-1309
Phone
(601) 693-0216
Fax
(601) 693-6313
NPI assigned
Jun 29, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 23514 MS
Allergy & Immunology (Internal Medicine) Physician 207RA0201X 23514 MS Primary

Addresses

Primary practice location

3704 Highway 39 N
Meridian, MS 39301-1309

Mailing address

1513 Lakeland Dr Ste 101
Jackson, MS 39216-4829
Phone (601) 354-4836

Other identifiers 1

IdentifierTypeStateIssuer
09975030MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20150805007613 MS Practitioner - Internal MedicinePractitioner - Allergy/Immunology 3375857204 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Allergy/Immunology
Education
University of Mississippi School of Medicine, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Mississippi Asthma and Allergy Clinic PAGroup PAC ID 7416993522, 14 clinicians

Practice addresses (Care Compare)

3704 Hwy 39 N
Meridian, MS 39301-1309
Phone (601) 693-0216

Hospital & facility affiliations

  • Anderson Regional Medical Center Hospital, Meridian, MS, CCN 250104

Merit-based Incentive Payment System (MIPS)

Final score
80.53 of 100Reported as group
Quality
61.06
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mississippi Asthma & Allergy Clinic PA CurrentSince May 1, 2021 Accepting new patients

Locations

1513 Lakeland Dr
Ste 101
Jackson, MS 39216
Phone (601) 354-4836

3704 Highway 39 N
Meridian, MS 39301
Phone (601) 693-0216

Interoperability endpoints

  • Direct secure messaging: stephen.leblanc.1@20428.direct.athenahealth.com

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 1

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": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1679837066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 LAKELAND DR STE 101",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164829",
            "telephone_number": "601-354-4836",
            "fax_number": "601-354-2619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3704 HIGHWAY 39 N",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393011309",
            "telephone_number": "601-693-0216",
            "fax_number": "601-693-6313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-29",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "23514",
            "primary": false
        },
        {
            "code": "207RA0201X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "MS",
            "license": "23514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09975030",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.