Active NPI
Leslie A Richardson, M.D.
- Developmental - Behavioral Pediatrics Physician
- Camp Lejeune, NC
National Provider Identifier
1780604751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental - Behavioral Pediatrics Physician
- License
- 95-00703
- Practice address
- 100 Brewster Blvd
Camp Lejeune, NC 28547-2575 - Phone
- (910) 450-3712
- Fax
- (910) 450-3766
- NPI assigned
- Jul 20, 2006
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 95-00703 | NC | |
| Developmental - Behavioral Pediatrics Physician | 2080P0006X | 95-00703 | NC | Primary |
Addresses
Primary practice location
100 Brewster Blvd
Camp Lejeune, NC 28547-2575
Mailing address
100 Brewster Blvd
Camp Lejeune, NC 28547-2575
Phone (910) 450-4127
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780604751 | Medicaid | NC | |
| 71547 | Other | NC | NCBCBS |
| 8971547 | Medicaid | NC | |
| NC2600 | Medicaid | SC |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95-00703 | NC | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736294400000",
"number": "1780604751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 BREWSTER BLVD",
"city": "CAMP LEJEUNE",
"state": "NC",
"postal_code": "285472575",
"telephone_number": "910-450-4127",
"fax_number": "910-450-3766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 BREWSTER BLVD",
"city": "CAMP LEJEUNE",
"state": "NC",
"postal_code": "285472575",
"telephone_number": "910-450-3712",
"fax_number": "910-450-3766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "LESLIE",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-20",
"last_updated": "2025-01-08",
"certification_date": "2025-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "95-00703",
"primary": false
},
{
"code": "2080P0006X",
"taxonomy_group": "",
"desc": "Pediatrics, Developmental - Behavioral Pediatrics",
"state": "NC",
"license": "95-00703",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1780604751",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCBCBS",
"identifier": "71547",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8971547",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NC2600",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Camp Lejeune, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.