Active NPI
Charles Leckie, D.O.
- Family Medicine Physician
- Tupelo, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 16467
- Practice address
- 903 Mississippi Dr
Tupelo, MS 38804-0928 - Phone
- (662) 377-4652
- Fax
- (662) 377-7925
- NPI assigned
- Mar 16, 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 | 16467 | MS | Primary |
Addresses
Primary practice location
903 Mississippi Dr
Tupelo, MS 38804-0928
Mailing address
450 E President Ave
Tupelo, MS 38801-5599
Phone (662) 377-4685
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00125648 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pontotoc Health Services, Inc. | Current | Accepting new patients | |
| Pontotoc Health Services, Inc. | Current | Accepting new patients | |
| North Mississippi Medical Clinics Inc | Current | Accepting new patients | |
| Pontotoc Health Services, Inc. | Current | Accepting new patients | |
| North Mississippi Medical Clinics Inc | Family Medicine | Current | Accepting new patients |
Locations
1913 Highway 45 N
Columbus, MS 39705
Phone (662) 328-1918
202 Main St
Ecru, MS 38841
Phone (662) 489-4345
400 Doctors Dr
New Albany, MS 38652
Phone (662) 534-5036
119 Robertson St
Okolona, MS 38860
Phone (662) 447-3882
2530 Jackson Ave W
Oxford, MS 38655
Phone (662) 236-5905
176 S Main St
Pontotoc, MS 38863
Phone (601) 489-5510
345 Highway 15 N
Pontotoc, MS 38863
Phone (662) 489-7430
845 S Madison St
Tupelo, MS 38801
Phone (601) 790-5025
903 Mississippi Dr
Tupelo, MS 38804
Phone (662) 377-4652
450 E President Ave
Tupelo, MS 38801
Phone (662) 377-3204
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Tupelo, MS
- NPI 1053469486
Family Medicine
-
dba Pontotoc Health Services CAH
- Critical Access Hospital
- Pontotoc, MS
- NPI 1821103516
-
dba The Women's Group West Point
- Obstetrics & Gynecology Physician
- West Point, MS
- NPI 1588769970
-
dba Pontotoc Medical Clinic
- Rural Health Clinic/Center
- Pontotoc, MS
- NPI 1538576772
-
dba Pontotoc Health Services CAH - Swing Bed
- Critical Access Hospital
- Pontotoc, MS
- NPI 1962512871
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346889600000",
"number": "1861461378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 E PRESIDENT AVE",
"city": "TUPELO",
"state": "MS",
"postal_code": "388015599",
"telephone_number": "662-377-4685",
"fax_number": "662-377-2755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "903 MISSISSIPPI DR",
"city": "TUPELO",
"state": "MS",
"postal_code": "388040928",
"telephone_number": "662-377-4652",
"fax_number": "662-377-7925"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LECKIE",
"first_name": "CHARLES",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-16",
"last_updated": "2012-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MS",
"license": "16467",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00125648",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tupelo, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.