Individual provider Active NPI

Leigh-Anne Lindenmuth Slack, D.O.

  • Family Medicine Physician
  • Fort Bragg, NC
National Provider Identifier
1770716938
Registry record updated Mar 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102202732 Issued in VA
Practice address
2817 Reilly Road
MCXC-Cod Credentials Womack Army Medical Center
Fort Bragg, NC 28310
Phone
(910) 907-8922
Fax
(910) 907-6069
NPI assigned
Sep 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0102202732 VA Primary
Emergency Medicine Physician 207P00000X 192120 NC
Family Medicine Physician 207Q00000X 192120 NC
Emergency Medicine Physician 207P00000X 0102202732 VA

Addresses

Primary practice location

2817 Reilly Road
MCXC-Cod Credentials Womack Army Medical Center
Fort Bragg, NC 28310

Mailing address

2817 Reilly Road
MCXC-Cod Credentials Womack Army Medical Center
Fort Bragg, NC 28310
Phone (910) 907-8922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130917000544 VA Practitioner - Family PracticePractitioner - Emergency Medicine 3274777131 Reassigns benefits to 2 organizations
I20131231001520 NC Practitioner - Family PracticePractitioner - Emergency Medicine 3274777131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

727 N Main St
Emporia, VA 23847-1274
Phone (240) 686-2300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.52 of 100Reported as group
Quality
91.6
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102202732VAMDEmergency Medicine Physician
192120NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates, P.a.,P.C. CurrentSince Apr 1, 2020 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Apr 1, 2020 Accepting new patients
Jones Lake Emergency Group, PC Emergency Medicine CurrentSince Mar 15, 2020 Accepting new patients
Alexandria Springfield Emergency Physicians PC Emergency Medicine CurrentSince Mar 15, 2020 Accepting new patients
Alexandria Springfield Emergency Physicians PC Emergency Medicine CurrentSince Mar 15, 2020 Accepting new patients
Columbus Emergency Group LLC Emergency Medicine CurrentSince Oct 1, 2013 Accepting new patients

Locations

500 Jefferson St
Whiteville, NC 28472
Phone (910) 642-1776

310 S McCaskey Rd
Williamston, NC 27892
Phone (252) 809-6133

60 E Roslyn Ct
Colonial Hgts, VA 23834
Phone (804) 281-8100

727 N Main St
Emporia, VA 23847
Phone (434) 348-4400

100 Fairview Dr
Franklin, VA 23851
Phone (757) 516-1153

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

200 Medical Park Blvd
Petersburg, VA 23805
Phone (804) 765-5000

Organizations & group practices 6

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": "1251936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395705600000",
    "number": "1770716938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 REILLY ROAD",
            "address_2": "MCXC-COD CREDENTIALS WOMACK ARMY MEDICAL CENTER",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "28310",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 REILLY ROAD",
            "address_2": "MCXC-COD CREDENTIALS WOMACK ARMY MEDICAL CENTER",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "28310",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLACK",
        "first_name": "LEIGH-ANNE",
        "middle_name": "LINDENMUTH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-03",
        "last_updated": "2014-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102202732",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "192120",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "192120",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0102202732",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, NC

Sources for this page

Verify at the official NPI Registry.