Individual provider Active NPI

Leah D Thomas, AU.D., CCC-A

  • Audiologist
  • Wilson, NC
National Provider Identifier
1720013352
Registry record updated Nov 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
11653 Issued in NC
Practice address
2115 Forest Hills Rd W Ste B
Wilson, NC 27893-3483
Phone
(252) 237-5527
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AY 1360 FL
Audiologist 231H00000X 11653 NC Primary

Addresses

Primary practice location

2115 Forest Hills Rd W Ste B
Wilson, NC 27893-3483

Mailing address

2501 Cottontail LN
Somerset, NJ 08873-5125
Phone (732) 529-7120

Other identifiers 2

IdentifierTypeStateIssuer
600485700MedicaidFL
0121159OtherFLGHI

Other names 1

  • Leah Dawn Ellcessor Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200130002554 NC Practitioner - Qualified Audiologist 0345246591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stinson Mobile Aud NC PLLCGroup PAC ID 6608120274, 7 clinicians

Practice addresses (Care Compare)

800 Tiffany Blvd
Suite 101
Rocky Mount, NC 27804-1807
Phone (248) 528-2116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11653NCMDDentist
AY 1360FLMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Stinson Mobile Aud NC PLLC Audiologist CurrentSince Dec 7, 2019 Accepting new patients
Hearusa Inc Past Accepting new patients
Audiology Distribution, LLC PastSince Apr 1, 2012 Accepting new patients

Locations

12910 Shelbyville Rd
Ste 300
Louisville, KY 40243
Phone (502) 214-0693

4350 Brownsboro Rd
Ste 200
Louisville, KY 40207
Phone (513) 771-7483

347 Hillsborough St
Raleigh, NC 27603

800 Tiffany Blvd
Ste 101
Rocky Mount, NC 27804

Interoperability endpoints

  • Direct secure messaging: leah.thomas.p13@direct.360care.nextgenshare.com

Organizations & group practices 3

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1720013352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 COTTONTAIL LN",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088735125",
            "telephone_number": "732-529-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 FOREST HILLS RD W STE B",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933483",
            "telephone_number": "252-237-5527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "LEAH",
        "middle_name": "D",
        "credential": "AU.D., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY 1360",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NC",
            "license": "11653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600485700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0121159",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEAH",
            "last_name": "ELLCESSOR",
            "middle_name": "DAWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wilson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.