NPIMap

Individual provider Active NPI

Lester Darrell Leggette, PA-AA

  • Anesthesiologist Assistant
  • Macon, GA
National Provider Identifier
1871584417
Registry record updated Jun 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
001796 Issued in GA
Practice address
380 Hospital Dr
Suite 410
Macon, GA 31217
Phone
(478) 746-5644
Fax
(229) 434-2502
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 001796 GA Primary

Addresses

Primary practice location

380 Hospital Dr
Suite 410
Macon, GA 31217

Mailing address

PO Box 2564
Macon, GA 31203-2565
Phone (478) 746-5644

Other identifiers 8

IdentifierTypeStateIssuer
580628385OtherGATRICARE
01780683OtherGAAMERIGROUP
362514OtherGAWELLCARE
100001416CMedicaidGA
100001416EMedicaidGA
100001416BMedicaidGA
100001416FMedicaidGA
100001416DMedicaidGA

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
Associate of Arts

State licenses

LicenseStateTypeSpecialty
001796GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Pathology Associates PC Current Accepting new patients
Palmyra Professional Fees LLC Past Accepting new patients
Palmyra Park Hospital, Inc. Past Accepting new patients

Locations

2000 Palmyra Rd
Albany, GA 31701
Phone (229) 434-2000

Organizations & group practices 3

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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370304000000",
    "number": "1871584417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2564",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312032565",
            "telephone_number": "478-746-5644",
            "fax_number": "478-745-4849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 HOSPITAL DR",
            "address_2": "SUITE 410",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31217",
            "telephone_number": "478-746-5644",
            "fax_number": "229-434-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGGETTE",
        "first_name": "LESTER",
        "middle_name": "DARRELL",
        "name_prefix": "Mr.",
        "credential": "PA-AA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2013-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "001796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "580628385",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01780683",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "362514",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100001416C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100001416E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100001416B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100001416F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100001416D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.

Verify at the official NPI Registry.