Individual provider Active NPI

Albert G Leroy Jr., M.D.

  • Urology Physician
  • Rock Hill, SC
National Provider Identifier
1912970484
Registry record updated Mar 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
6625 Issued in SC
Practice address
1780 Medical Park Dr
Rock Hill, SC 29732-1194
Phone
(803) 327-1116
Fax
(803) 327-6872
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 6625 SC Primary
Urology Physician 208800000X 30198 NC

Addresses

Primary practice location

1780 Medical Park Dr
Rock Hill, SC 29732-1194

Mailing address

9735 Kincey Ave
Suite 201
Huntersville, NC 28078-9118
Phone (704) 414-2870

Other identifiers 8

IdentifierTypeStateIssuer
066252MedicaidSC
279869OtherSCMAMSI
760688OtherSCGREAT WEST HLTHCARE
0411169OtherSCAETNA
26995OtherSCMEDCOST
89136H1MedicaidNC
136H1OtherNCBCBS OF NC
1905788OtherSCUNITED HEALTHCARE

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6625SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stone Institute of the Carolinas LLC Urology PastSince Apr 1, 1990 Accepting new patients
Carolina Urology Center, PA Urology PastSince Sep 15, 2003 Accepting new patients

Organizations & group practices 2

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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427760000000",
    "number": "1912970484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9735 KINCEY AVE",
            "address_2": "SUITE 201",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280789118",
            "telephone_number": "704-414-2870",
            "fax_number": "704-414-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 MEDICAL PARK DR",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321194",
            "telephone_number": "803-327-1116",
            "fax_number": "803-327-6872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEROY",
        "first_name": "ALBERT",
        "middle_name": "G",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2015-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "SC",
            "license": "6625",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "30198",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "066252",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "279869",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT WEST HLTHCARE",
            "identifier": "760688",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0411169",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "26995",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89136H1",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "136H1",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1905788",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; 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.