Leah Michelle Bagley, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

24751 Issued in SC

Practice address

420 Polifka Dr
Shaw Afb, SC 29152-5100

Phone

(803) 895-6191

NPI assigned

Mar 27, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC, OH, KY3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Comprehensive Rehab Consultants PLLC 251 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25140/brand/1/csg/1/fhir/r4

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.

• Comprehensive Rehab Consultants PLLC

  • Physical Medicine & Rehabilitation Physician
  • Middle River, MD
  • NPI 1710529771

  Family, KY, OH

  Medicare reassignment Care Compare group NPD
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1073234928

  SC

  Medicare reassignment NPD
• Three Rivers Medical Associates, PA

  • Internal Medicine Physician
  • Irmo, SC
  • NPI 1760445597

  Family, SC

  Medicare reassignment NPD
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Summerville, SC
  • NPI 1366123739
  NPD
• Palmetto Primary Care Physicians, LLC

  • Internal Medicine Physician
  • Columbia, SC
  • NPI 1437712445
  NPD
• Three Rivers Medical Associates, PA

  • Internal Medicine Physician
  • Columbia, SC
  • NPI 1124901459
  NPD

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1962030809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 POLIFKA DR",
            "city": "SHAW AFB",
            "state": "SC",
            "postal_code": "291525100",
            "telephone_number": "803-895-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 POLIFKA DR",
            "city": "SHAW AFB",
            "state": "SC",
            "postal_code": "291525100",
            "telephone_number": "803-895-6191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 Gateway Corporate Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292038801",
            "country_code": "US",
            "telephone_number": "839-200-7815",
            "fax_number": "803-891-7085",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7430 College St",
            "address_purpose": "LOCATION",
            "city": "Irmo",
            "state": "SC",
            "postal_code": "290632903",
            "country_code": "US",
            "telephone_number": "839-200-7810",
            "fax_number": "803-891-7085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAGLEY",
        "first_name": "LEAH",
        "middle_name": "MICHELLE",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-27",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN262574",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "24751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 20TH Medgrp-Shaw
• 20TH Medgrp-Shaw
• Lauren Carol Allain, FNP-BC
• Sidonia Lee Alo, IDMT
• John Paul Andrew, DO
• Jeffrey Allan Banks, M.D.
• John Alan Barnett, RPH
• Suzan Beattie
• Misty Marie Bennett, DDS
• Eric Black, IDMT

• All providers in Shaw Afb, SC
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.