Individual provider Active NPI

Leigh Ellen Freeman, PA-C, MMS

  • Physician Assistant
  • Cary, NC
National Provider Identifier
1982891818
Registry record updated Jan 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001001026 Issued in NC
Practice address
105 Ridgeview Dr
Cary, NC 27511-9998
Phone
(919) 467-5543
Fax
(919) 469-2391
NPI assigned
Sep 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001001026 NC Primary

Addresses

Primary practice location

105 Ridgeview Dr
Cary, NC 27511-9998

Mailing address

105 Ridgeview Dr
Cary, NC 27511-9998
Phone (919) 467-5543

Other identifiers 1

IdentifierTypeStateIssuer
001001026OtherNCNC LICENSE

Other names 1

  • Leigh Ellen Floyd Former name

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

State licenses

LicenseStateTypeSpecialty
001001026NCMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1982891818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 RIDGEVIEW DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275119998",
            "telephone_number": "919-467-5543",
            "fax_number": "919-469-2391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 RIDGEVIEW DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275119998",
            "telephone_number": "919-467-5543",
            "fax_number": "919-469-2391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "LEIGH",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "PA-C, MMS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-25",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001001026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC LICENSE",
            "identifier": "001001026",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEIGH",
            "last_name": "FLOYD",
            "middle_name": "ELLEN",
            "credential": "PA-C, MMS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.