Leading Edge Medical

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

LEADING EDGE MEDICAL

Practice address

1530 S Val Vista Dr Ste 106
Gilbert, AZ 85296-3860

Phone

(480) 664-6061

Fax

(480) 584-6336

NPI assigned

Jul 24, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Benjamin JohnsonNPI 1609029057

Title

Owner

Phone

(480) 664-6061

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ashley Ann Foster, FNP

  • Family Nurse Practitioner
  • Queen Creek, AZ
  • NPI 1235883935
  Medicare reassignment NPD
• Tammatha Lynn Jones, FNP-C

  • Family Nurse Practitioner
  • San Tan Valley, AZ
  • NPI 1417439274
  Medicare reassignment NPD
• Marc C Raciti, PA-C

  • Physician Assistant
  • Gilbert, AZ
  • NPI 1295799674
  Medicare reassignment
• Benjamin J Johnson, DC

  • Chiropractor
  • Gilbert, AZ
  • NPI 1609029057
  Authorized official Same address or phone
• Samantha Teel, FNP-C

  • Family Nurse Practitioner
  • Tempe, AZ
  • NPI 1033799465
  NPD
• Samantha June Nazaroff, DNP

  • Adult Health Nurse Practitioner
  • Hagerstown, MD
  • NPI 1467975698
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1861915688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 S VAL VISTA DR STE 106",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963860",
            "telephone_number": "480-664-6061",
            "fax_number": "480-584-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 S VAL VISTA DR STE 106",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963860",
            "telephone_number": "480-664-6061",
            "fax_number": "480-584-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEADING EDGE MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-24",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-664-6061"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quang Le, DDS
• Thanh Le
• Vu M Le
• Heather L Leach, SLPA
• Ronald Leach, COTA/L
• Kaitlyn Leahey, PA-C
• Leaps and Bounds Therapy Center
• Richard A Lease, RNFA
• James Thomas Leathem, DO
• Samantha Leavitt, LMSW

• General Practice Physician in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• General Practice Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.