Individual provider Active NPI

Teri Lee Leishman, APP AG-CNS

  • Perioperative Clinical Nurse Specialist
  • Grand Junction, CO
National Provider Identifier
1700517794
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Perioperative Clinical Nurse SpecialistTaxonomy code 364SP2800X
License
1626684 Issued in CO
Practice address
2108 Monument Village Cir
Grand Junction, CO 81507-1070
Phone
(801) 645-1175
NPI assigned
Jun 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Perioperative Clinical Nurse Specialist 364SP2800X 1626684 CO Primary

Addresses

Primary practice location

2108 Monument Village Cir
Grand Junction, CO 81507-1070

Mailing address

2108 Monument Village Cir
Grand Junction, CO 81507-1070
Phone (801) 645-1175

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230814000069 FL Practitioner - Certified Clinical Nurse Specialist (CNS) 9234591959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sage Infusion, LLCGroup PAC ID 1254660467, 44 clinicians

Practice addresses (Care Compare)

910 Old Camp Rd
Suite 196
The Villages, FL 32162-5605
Phone (352) 565-5553

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1626684COMDPerioperative Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Sage Infusion, LLC CurrentSince Jun 8, 2023 Accepting new patients

Locations

1090 NW 8th Ave
Ste 30
Gainesville, FL 32601
Phone (352) 450-8886

8550 NE 138th Ln
Ste 502
Lady Lake, FL 32159
Phone (352) 810-3536

3200 SW 34th Ave
Ste 502
Ocala, FL 34474
Phone (352) 237-7355

2191 9th Ave N
Ste 105
St Petersburg, FL 33713
Phone (727) 209-1419

4728 N Habana Ave
Ste 101B
Tampa, FL 33614
Phone (813) 775-9997

2789 Brownwood Blvd
The Villages, FL 32163
Phone (352) 450-3080

910 Old Camp Rd
Ste 196
The Villages, FL 32162
Phone (352) 565-5553

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": "1655769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1700517794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 MONUMENT VILLAGE CIR",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815071070",
            "telephone_number": "801-645-1175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 MONUMENT VILLAGE CIR",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815071070",
            "telephone_number": "801-645-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEISHMAN",
        "first_name": "TERI",
        "middle_name": "LEE",
        "credential": "APP AG-CNS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-21",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP2800X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Perioperative",
            "state": "CO",
            "license": "1626684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.