Lesle Spain

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R31784 Issued in CT

Practice address

743 South Ave
Bridgeport, CT 06604-5810

Phone

(203) 330-6000

Fax

(203) 330-6013

NPI assigned

Aug 12, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South-West Community Health Center IncGroup PAC ID 2466445200, 52 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lspain577586@direct.ochin.org

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.

• South-West Community Health Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bridgeport, CT
  • NPI 1699703686
  Medicare reassignment Care Compare group NPD
• Neighborhood Health, Inc.

  • General Practice Physician
  • Torrington, CT
  • NPI 1043544489

  Family

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497225600000",
    "number": "1740436674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 ALBION STREET",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066052605",
            "telephone_number": "203-332-3155",
            "fax_number": "203-330-6013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 SOUTH AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066045810",
            "telephone_number": "203-330-6000",
            "fax_number": "203-330-6013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAIN",
        "first_name": "LESLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2017-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "R31784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236130",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South-West Community Health Center, Inc
• Southwest Community Health Center
• Southwest Community Health Center
• Southwestern Connecticut Agency on Aging
• Andrew Spadinger, DDS
• Lyric Nicole Spain, LPN
• Jason Elijah Spann, LCSW
• Neil Specht, MD
• Dasha Spell, LPC,NCC
• Emily Spellman

• Family Nurse Practitioner in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.