Active NPI
James Edward Leedy, M.D.
- Family Medicine Physician
- Richland, WA
National Provider Identifier
1811909005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD00019854
- Practice address
- 1135 Jadwin Ave
Richland, WA 99352-3434 - Phone
- (509) 942-3300
- Fax
- (509) 946-1868
- NPI assigned
- Aug 13, 2006
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD00019854 | WA | Primary |
Addresses
Primary practice location
1135 Jadwin Ave
Richland, WA 99352-3434
Mailing address
3900 S Zintel Way
Kennewick, WA 99337-5092
Phone (509) 942-3627
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0304494 | Other | WA | L&I NUMBER |
| 1811909005 | Medicaid | WA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378944000000",
"number": "1811909005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3900 S ZINTEL WAY",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "993375092",
"telephone_number": "509-942-3627",
"fax_number": "509-942-2268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1135 JADWIN AVE",
"city": "RICHLAND",
"state": "WA",
"postal_code": "993523434",
"telephone_number": "509-942-3300",
"fax_number": "509-946-1868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEEDY",
"first_name": "JAMES",
"middle_name": "EDWARD",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-13",
"last_updated": "2013-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD00019854",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I NUMBER",
"identifier": "0304494",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1811909005",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Richland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.