Active NPI
Leigh Bostick Womble, FNP
- Family Nurse Practitioner
- Rosedale, MS
National Provider Identifier
1720377641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- RN210599
- Practice address
- 512 Levee Street, Box 310
Rosedale, MS 38769-0310 - Phone
- (662) 759-6806
- Fax
- (662) 759-6771
- NPI assigned
- Mar 31, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Health Clinical Nurse Specialist | 364SF0001X | R544779 | MS | |
| Family Nurse Practitioner | 363LF0000X | RN210599 | GA | Primary |
Addresses
Primary practice location
512 Levee Street, Box 310
Rosedale, MS 38769-0310
Mailing address
512 Levee Street, Box 310
Rosedale, MS 38769-0310
Phone (662) 759-6806
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R544779 | MS | MD | Family Health Clinical Nurse Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rosedale Family Medical Center, P.C. | Past | Accepting new patients |
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.
-
- Family Medicine Physician
- Rosedale, MS
- NPI 1043223340
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519948800000",
"number": "1720377641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "512 LEVEE STREET, BOX 310",
"city": "ROSEDALE",
"state": "MS",
"postal_code": "387690310",
"telephone_number": "662-759-6806",
"fax_number": "662-759-6771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "512 LEVEE STREET, BOX 310",
"city": "ROSEDALE",
"state": "MS",
"postal_code": "387690310",
"telephone_number": "662-759-6806",
"fax_number": "662-759-6771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOMBLE",
"first_name": "LEIGH",
"middle_name": "BOSTICK",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-31",
"last_updated": "2018-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "364SF0001X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Family Health",
"state": "MS",
"license": "R544779",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "RN210599",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rosedale, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.