Leeann M Acker, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

6571 Issued in AZ

Practice address

14541 W Indian School Rd
Ste 600
Goodyear, AZ 85395-9243

Phone

(623) 535-5599

Fax

(623) 535-4696

NPI assigned

Nov 10, 2016

Last updated

Nov 10, 2016By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: lacker1032382@direct.hfhs.org
• Direct secure messaging: leeann.acker.1@27127.direct.athenahealth.com

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

{
    "created_epoch": "1478736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1760924534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14541 W INDIAN SCHOOL RD",
            "address_2": "STE 600",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853959243",
            "telephone_number": "623-535-5599",
            "fax_number": "623-535-4696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14541 W INDIAN SCHOOL RD",
            "address_2": "STE 600",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853959243",
            "telephone_number": "623-535-5599",
            "fax_number": "623-535-4696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKER",
        "first_name": "LEEANN",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-10",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.