Individual provider Active NPI

Leslie Crosland Williams

  • Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1992053854
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5005780 Issued in NC
Practice address
3001 Lyndhurst Ave
Winston Salem, NC 27103-4007
Phone
(336) 765-0383
Fax
(336) 760-6918
NPI assigned
Aug 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5005780 NC Primary

Addresses

Primary practice location

3001 Lyndhurst Ave
Winston Salem, NC 27103-4007

Mailing address

3001 Lyndhurst Ave
Winston Salem, NC 27103-4007
Phone (336) 765-0383

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lwilliams177750@direct.novant.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20121003000084 NC Practitioner - Nurse Practitioner 6507015757 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5005780NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Medical Group PA CurrentSince Sep 4, 2012 Accepting new patients

Locations

3001 Lyndhurst Ave
Winston Salem, NC 27103
Phone (336) 765-0383

Organizations & group practices 1

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": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1992053854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 LYNDHURST AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034007",
            "telephone_number": "336-765-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 LYNDHURST AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034007",
            "telephone_number": "336-765-0383",
            "fax_number": "336-760-6918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "LESLIE",
        "middle_name": "CROSLAND",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-27",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5005780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lwilliams177750@direct.novant.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3001 Lyndhurst Ave",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271034007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.