Individual provider Active NPI

Jean M Leslie, APRN

  • Family Nurse Practitioner
  • Harrison, AR
National Provider Identifier
1801066808
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A03155ANP Issued in AR
Practice address
306 N Chestnut St
Harrison, AR 72601-4453
Phone
(870) 741-8559
Fax
(870) 741-8423
NPI assigned
Mar 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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 A03155ANP AR Primary

Addresses

Primary practice location

306 N Chestnut St
Harrison, AR 72601-4453

Mailing address

306 N Chestnut St
Harrison, AR 72601-4453
Phone (870) 741-8559

Other identifiers 4

IdentifierTypeStateIssuer
A03155ANPOtherARAPN LICENSE
129735729MedicaidAR
136428729MedicaidAR
199554758MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20130716000852 AR Practitioner - Nurse Practitioner 9739329632 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A03155ANPARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McClintock Family Medicine CurrentSince Mar 30, 2016 Accepting new patients

Locations

306 N Chestnut St
Harrison, AR 72601
Phone (870) 701-5051

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CAJIAA

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1801066808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 N CHESTNUT ST",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726014453",
            "telephone_number": "870-741-8559",
            "fax_number": "870-741-8423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 N CHESTNUT ST",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726014453",
            "telephone_number": "870-741-8559",
            "fax_number": "870-741-8423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESLIE",
        "first_name": "JEAN",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-05",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A03155ANP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APN LICENSE",
            "identifier": "A03155ANP",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129735729",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136428729",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199554758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrison, AR

Sources for this page

Verify at the official NPI Registry.