NPIMap

Individual provider Active NPI

Lesleigh Gail Prewitt

  • Physician Assistant
  • Williamsburg, KY
National Provider Identifier
1831950260
Registry record updated Oct 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
TC105 Issued in KY
Practice address
4490 Redbird Rd
Williamsburg, KY 40769-6100
Phone
(606) 304-2353
NPI assigned
Jan 22, 2024
Last updated
Oct 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TC105 KY Primary
Physician Assistant 363A00000X 6100 TN

Addresses

Primary practice location

4490 Redbird Rd
Williamsburg, KY 40769-6100

Mailing address

4490 Redbird Rd
Williamsburg, KY 40769-6100
Phone (606) 304-2353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241019000145 TN Practitioner - Physician Assistant 5890227508 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians

Practice addresses (Care Compare)

1201 Bishop St
Union City, TN 38261-5403
Phone (731) 885-2410

300 Med Tech Pkwy
Johnson City, TN 37604-2277
Phone (423) 302-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6100TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Dec 30, 2025 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Dec 30, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Dec 30, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Dec 30, 2025 Accepting new patients

Locations

7348 E Brainerd Rd
Chattanooga, TN 37421
Phone (205) 822-8038

3430 E Andrew Johnson Hwy
Ste 1
Greeneville, TN 37745
Phone (423) 820-0033

Organizations & group practices 5

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 6

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": "1705881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792108800000",
    "number": "1831950260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4490 REDBIRD RD",
            "city": "WILLIAMSBURG",
            "state": "KY",
            "postal_code": "407696100",
            "telephone_number": "606-304-2353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4490 REDBIRD RD",
            "city": "WILLIAMSBURG",
            "state": "KY",
            "postal_code": "407696100",
            "telephone_number": "606-304-2353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREWITT",
        "first_name": "LESLEIGH",
        "middle_name": "GAIL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-22",
        "last_updated": "2026-10-16",
        "certification_date": "2026-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC105",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "6100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, KY

Sources for this page

Verify at the official NPI Registry.