Leo P O'Connell MD PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

0101024069 Issued in VA

Legal business name

LEO P O'CONNELL MD PC

Doing business as

BREAST DIAGNOSTIC CENTER

Practice address

704 Thimble Shoals Blvd
Suite 600B
Newport News, VA 23606-4544

Phone

(757) 595-8650

Fax

(757) 591-8651

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Tina Harris

Title

Medical Billing Clerk

Phone

(757) 595-8650

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• BREAST DIAGNOSTIC CENTER Doing business as

Locations

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1952426470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 THIMBLE SHOALS BLVD",
            "address_2": "SUITE 600B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064544",
            "telephone_number": "757-595-8650",
            "fax_number": "757-591-8651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 THIMBLE SHOALS BLVD",
            "address_2": "SUITE 600B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064544",
            "telephone_number": "757-595-8650",
            "fax_number": "757-591-8651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEO P O'CONNELL MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "MEDICAL BILLING CLERK",
        "authorized_official_telephone_number": "757-595-8650",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101024069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "630000723",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "196140",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7243481",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BREAST DIAGNOSTIC CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John C Leist III, DMD MS
• Lena Transit Service LLC.
• Brian Christopher Lenczewski, MD
• Lauren Elizabeth Lenertz, PA
• Leo P O'Connell MD PC
• Kassandra Ellis Leonard, RN
• Tanisha Leonard, LPC
• Julia Lee Lerner, MD, MA
• Andrea Lese, M.D.
• Joyce Leshore

• Specialist in Newport News, VA
• Providers in Newport News, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.