Active NPI
Leonard Shirley Jr., LMSW
- Social Worker
- Fort Defiance, AZ
National Provider Identifier
1801151493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- M-06072
- Practice address
- Corner of Route N12 and N7
Fort Defiance, AZ 86504-0649 - Phone
- (928) 729-8021
- Fax
- (928) 729-8530
- NPI assigned
- Jul 10, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | M-06072 | NM | Primary |
Addresses
Primary practice location
Corner of Route N12 and N7
Fort Defiance, AZ 86504-0649
Mailing address
PO Box 649
Fort Defiance, AZ 86504-0649
Phone (928) 729-8021
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
Corner of Route N12 and N7
Fdihb Inc.
Fort Defiance, AZ 86504-0649
Phone (928) 729-8082
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-06072 | NM | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Fort Defiance Indian Hospital Board, Incorporation | Current | Accepting new patients |
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.
-
- General Acute Care Hospital
- Fort Defiance, AZ
- NPI 1477876639
TX
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341878400000",
"number": "1801151493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 649",
"city": "FORT DEFIANCE",
"state": "AZ",
"postal_code": "865040649",
"telephone_number": "928-729-8021",
"fax_number": "928-729-8530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CORNER OF ROUTE N12 AND N7",
"city": "FORT DEFIANCE",
"state": "AZ",
"postal_code": "865040649",
"telephone_number": "928-729-8021",
"fax_number": "928-729-8530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIRLEY",
"first_name": "LEONARD",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-10",
"last_updated": "2012-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NM",
"license": "M-06072",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Defiance, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.