Individual provider Active NPI

Leah Malcom Ainslie, FNP-C

  • Family Nurse Practitioner
  • Madison, GA
National Provider Identifier
1891103206
Registry record updated Jul 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN164840 Issued in GA
Practice address
2005 S Main St Ste 200
Madison, GA 30650-2055
Phone
(706) 752-1266
Fax
(706) 752-0286
NPI assigned
Jul 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN164840 GA Primary

Addresses

Primary practice location

2005 S Main St Ste 200
Madison, GA 30650-2055

Mailing address

2005 S Main St Ste 200
Madison, GA 30650-2055
Phone (706) 752-1266

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150529000591 GA Practitioner - Nurse Practitioner 8325368574 Reassigns benefits to 10 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN164840GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clarke County Department of Health CurrentSince Jun 3, 2024 Accepting new patients
Jackson County Health Department CurrentSince Jun 3, 2024 Accepting new patients

Locations

345 N Harris St
Athens, GA 30601
Phone (706) 389-6921

345 N Harris St
Ste 100
Athens, GA 30601
Phone (706) 425-2935

220 Research Dr
Athens, GA 30605
Phone (706) 583-2856

341 Stan Evans Dr
Jefferson, GA 30549
Phone (706) 367-5204

Organizations & group practices 10

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": "1406592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1891103206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 S MAIN ST STE 200",
            "city": "MADISON",
            "state": "GA",
            "postal_code": "306502055",
            "telephone_number": "706-752-1266",
            "fax_number": "706-752-0286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 S MAIN ST STE 200",
            "city": "MADISON",
            "state": "GA",
            "postal_code": "306502055",
            "telephone_number": "706-752-1266",
            "fax_number": "706-752-0286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AINSLIE",
        "first_name": "LEAH",
        "middle_name": "MALCOM",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-29",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN164840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, GA

Sources for this page

Verify at the official NPI Registry.