Individual provider Active NPI

Leslie L Henry, NP

  • Family Nurse Practitioner
  • Greeneville, TN
National Provider Identifier
1780937763
Registry record updated Apr 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
16889 Issued in TN
Practice address
555 Justis Dr
Greeneville, TN 37745-4288
Phone
(423) 783-7965
Fax
(423) 783-7970
NPI assigned
Oct 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 16889 TN Primary

Addresses

Primary practice location

555 Justis Dr
Greeneville, TN 37745-4288

Mailing address

1225 E Weisgarber Rd
Suite 200
Knoxville, TN 37909-2604
Phone (865) 584-4747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20130204000350 TN Practitioner - Nurse Practitioner 7113171968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group, PLLCGroup PAC ID 2860396330, 636 clinicians

Practice addresses (Care Compare)

1225 E Weisgarber Rd
Suite 200
Knoxville, TN 37849-4016
Phone (865) 938-3627

1275 Dick Lonas Rd
Knoxville, TN 37909-1326

201 E Emory Rd
Powell, TN 37849-4016
Phone (865) 938-3627

555 Justis Dr
Greeneville, TN 37745-4288
Phone (423) 783-7965

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
16889TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, PLLC CurrentSince Jul 28, 2014 Accepting new patients
Summit Medical Group PLLC PastSince Mar 24, 2024 Accepting new patients
Summit Medical Group,PLLC Past Accepting new patients
Summit Medical Group, PLLC Past Accepting new patients
Tennessee Cancer Specialists PLLC Past Accepting new patients
Tennessee Cancer Specialists PLLC Past Accepting new patients

Locations

555 Justis Dr
Greeneville, TN 37745
Phone (423) 254-6460

1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627

Interoperability endpoints

  • Direct secure messaging: leslie.henry.1@20785.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1780937763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 E WEISGARBER RD",
            "address_2": "SUITE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092604",
            "telephone_number": "865-584-4747",
            "fax_number": "865-584-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 JUSTIS DR",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377454288",
            "telephone_number": "423-783-7965",
            "fax_number": "423-783-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "LESLIE",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-16",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "16889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeneville, TN

Sources for this page

Verify at the official NPI Registry.