Individual provider Active NPI

Leroy W Hodges, M.D.

  • Surgery Physician
  • Harlan, IA
National Provider Identifier
1700856432
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD-50086 Issued in IA
Practice address
1220 Chatburn Ave
Harlan, IA 51537-2009
Phone
(712) 755-4376
Fax
(712) 755-4347
NPI assigned
Jan 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 66366 TN
Surgery Physician 208600000X MD-50086 IA Primary
Surgery Physician 208600000X 30115 MN

Addresses

Primary practice location

1220 Chatburn Ave
Harlan, IA 51537-2009

Mailing address

1220 Chatburn Ave
Harlan, IA 51537-2009
Phone (712) 755-4376

Other identifiers 1

IdentifierTypeStateIssuer
961423100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20210302001816 AL Practitioner - General Surgery 2163430554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vaughan Physician Practices, LLCGroup PAC ID 8123126851, 12 clinicians

Practice addresses (Care Compare)

1023 Medical Ctr Pkwy
Suite 309
Selma, AL 36701-7738
Phone (334) 875-7509

Hospital & facility affiliations

  • Vaughan Regional Medical Center Parkway Campus Hospital, Selma, AL, CCN 010118

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy73
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux34
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30115MNMDSurgery Physician
66366TNMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vaughan Physician Practices, LLC Current Accepting new patients
Vaughan Physician Practices LLC CurrentSince Jun 1, 2024 Accepting new patients
Vaughan Physician Practices LLC Surgery CurrentSince Jun 1, 2024 Accepting new patients
Hodges Surgical Clinic, P.a. Surgery PastSince Aug 22, 2007 Accepting new patients
Vaughan Physician Practices LLC Surgery Past Accepting new patients

Locations

1023 Medical Center Pkwy
Ste 300
Selma, AL 36701
Phone (334) 683-9085

1023 Medical Center Pkwy
Ste 401
Selma, AL 36701
Phone (334) 875-7173

1023 Medical Center Pkwy
Ste 309
Selma, AL 36701
Phone (334) 875-7509

1023 Medical Center Pkwy
Ste 305
Selma, AL 36701
Phone (334) 801-9952

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19364/brand/1/csg/21/fhir/r4
  • Direct secure messaging: le.roy.hodges.1@3503.direct.athenahealth.com
  • Direct secure messaging: leroy.hodges.1@19364.direct.athenahealth.com
  • Direct secure messaging: leroy.hodges.1@3503.direct.athenahealth.com

Organizations & group practices 5

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": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1700856432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 CHATBURN AVE",
            "city": "HARLAN",
            "state": "IA",
            "postal_code": "515372009",
            "telephone_number": "712-755-4376",
            "fax_number": "712-755-4347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 CHATBURN AVE",
            "city": "HARLAN",
            "state": "IA",
            "postal_code": "515372009",
            "telephone_number": "712-755-4376",
            "fax_number": "712-755-4347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGES",
        "first_name": "LEROY",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "66366",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "MD-50086",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "30115",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "961423100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlan, IA

Sources for this page

Verify at the official NPI Registry.