Individual provider Active NPI

Jeffrey Paul Leppert, RN APN-C

  • Adult Health Nurse Practitioner
  • Medford, OR
National Provider Identifier
1811027055
Registry record updated Oct 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
201050041NP Issued in OR
Practice address
825 Bennett Ave
Medford, OR 97504-6715
Phone
(541) 779-5228
Fax
(541) 772-1533
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2013

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 26NR11867300 NJ
Adult Health Nurse Practitioner 363LA2200X 26NJ00142100 NJ
Adult Health Nurse Practitioner 363LA2200X AP60120714 WA
Adult Health Nurse Practitioner 363LA2200X ARNP9261574 FL
Adult Health Nurse Practitioner 363LA2200X 201050041NP OR Primary

Addresses

Primary practice location

825 Bennett Ave
Medford, OR 97504-6715

Mailing address

825 Bennett Ave
Medford, OR 97504-6715
Phone (541) 779-5228

Other identifiers 1

IdentifierTypeStateIssuer
500642563MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20120320000409 OR Practitioner - Nurse Practitioner 4688712649 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NR11867300NJMDEmergency Registered Nurse
ARNP9261574FLMDAdult Health Nurse Practitioner
26NJ00142100NJMDAdult Health Nurse Practitioner
AP60120714WAMDAdult Health Nurse Practitioner

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382313600000",
    "number": "1811027055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 BENNETT AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046715",
            "telephone_number": "541-779-5228",
            "fax_number": "541-772-1533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 BENNETT AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046715",
            "telephone_number": "541-779-5228",
            "fax_number": "541-772-1533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEPPERT",
        "first_name": "JEFFREY",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "RN APN-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2013-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "NJ",
            "license": "26NR11867300",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00142100",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP60120714",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9261574",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "201050041NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500642563",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.