Jody J Leisholmn, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

698 Issued in AK

Practice address

563 Brendible St.
Metlakatla, AK 99926

Phone

(907) 886-4741

NPI assigned

Oct 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Merit-based Incentive Payment System (MIPS)

Final score

96.38 of 100Reported as group

Quality

80.82

Promoting interoperability

91

Improvement activities

40

Cost

84.44

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Pine Ridge Indian Health Service Hospital

  dba Pine Ridge IHS Hospital

  • General Acute Care Hospital
  • Pine Ridge, SD
  • NPI 1497786412

  TX

  Medicare reassignment NPD
• Pine Ridge Indian Health Service Hospital

  dba LaCreek District Clinic

  • Clinic/Center
  • Martin, SD
  • NPI 1003208257
  NPD

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922196468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 675",
            "city": "METLAKATLA",
            "state": "AK",
            "postal_code": "999260675",
            "telephone_number": "907-886-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "563 BRENDIBLE ST.",
            "city": "METLAKATLA",
            "state": "AK",
            "postal_code": "99926",
            "telephone_number": "907-886-4741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEISHOLMN",
        "first_name": "JODY",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AK",
            "license": "698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Ashley Guthrie
• Sylvia Ann Guthrie, BHA 1; CDC1
• Tamara Alvina Guthrie
• Dashon Malik King
• Alonzo Craig Leisholmn Sr., CHA-IV
• Ivan Lomeli
• Hayley Celeste Lynch
• Lillian Darcy McGilton, DHAT
• Timothy William McGrath
• Prudence Ann McKay

• Medical Physician Assistant in Metlakatla, AK
• Providers in Metlakatla, AK by specialty
• Medical Physician Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.