PRIMUS LEIGHTON STREET (NPI# 1851668784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851668784 |
| Entity Type | Organization |
| Organization Name | PRIMUS LEIGHTON STREET |
| Practice Address |
132 Leighton Dr Leesburg GA 31763-4786 |
| Mailing Address |
1120 W Broad Ave Ste C6 Albany GA 31707-4386 |
| Practice Telephone | 2294304138 |
| Enumeration Date | 2011-11-21 |
| Last Update Date | 2011-11-21 |
| Authorized Official Name | DAVID BARANKO (CFO) |
| Authorized Official Telephone | 2294300416 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
Ambulatory Health Care Facilities |
| Street Address |
132 LEIGHTON DR |
| City | LEESBURG |
| State | GA |
| Zip Code | 31763-4786 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790150423 | Jamie Perrella Flynn-pressley | Counselor | 112 Cris Ann St., Leesburg, GA 31763 | 2015-12-07 |
| 1023429511 | Brookstone Medical LLC | Durable Medical Equipment & Medical Supplies | 123 Hugh Rd, Leesburg, GA 31763 | 2014-05-19 |
| 1124370796 | Freds Stores of Tennessee Inc | Pharmacy | 118 Robert B Lee Drive, Leesburg, GA 31763 | 2012-10-08 |
| 1255649273 | Lee County Optical LLC | Optometrist | 1569 Highway 19 South, Leesburg, GA 31763 | 2010-09-24 |
| 1851572473 | Shaun Nicholas Price | Chiropractor | 152 Robert B Lee Dr, # 31, Leesburg, GA 31763 | 2007-11-26 |
| 1710042007 | Williams & Bush Partnership | Dentist | 919 Us Hwy 19 South, Leesburg, GA 31763 | 2006-12-27 |
| 1063570398 | Lee County Board of Education | Local Education Agency (LEA) | 126 Starksville Avenue, North, Leesburg, GA 31763 | 2006-12-06 |
| 1225109929 | Lee County School System | Local Education Agency (LEA) | 126 Starksville Avenue North, Leesburg, GA 31763 | 2006-11-13 |
| 1073682936 | Adams' Loving Pro Home Health Care Inc. | Home Health | 1277 Hwy 82 West, 121, Leesburg, GA 31763 | 2006-11-07 |
| 1225132699 | Deirdre Mae Clairewen Lawson | Internal Medicine | 235 Walnut Street, Leesburg, GA 31763 | 2006-09-07 |
| Find all providers in zip 31763 | ||||
| Taxonomy Code | 261QD1600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Developmental Disabilities |
| An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033732268 | Hearts for Companion LLC | Clinic/Center | 1310 Peters Dr, Leesburg, FL 34748-4041 | 2020-05-21 |
| 1518596030 | Jessica Marie Bastian | Clinic/Center | 1704 W Main St, Leesburg, FL 34748-4861 | 2020-04-06 |
| 1215468558 | Charra Vanae Taylor | Clinic/Center | 34035 Hunt Ave, Leesburg, FL 34788-4368 | 2017-03-27 |
| 1821627282 | Adrienne Martin | Clinic/Center | 292 Bent Oak Ct, Leesburg, FL 34748-9557 | 2020-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922653534 | Five Star Education Advocacy Group Inc | Clinic/Center | 978 Fellowship Rd, Fairburn, GA 30213-1789 | 2019-08-09 |
| 1205329687 | Advantage Behavioral Health Systems | Clinic/Center | 638 Michael Cir., Monroe, GA 30655 | 2018-06-11 |
| 1215420690 | Advantage Behavioral Health Systems | Clinic/Center | 1801 Prospect Rd., Madison, GA 30650 | 2018-06-11 |
| 1285149955 | Alicia Gordon | Clinic/Center | 132 Carol Cir, Fitzgerald, GA 31750-8128 | 2017-12-04 |
| 1225567597 | Vincentia Paul-constantin | Clinic/Center | 2867 Country House Lane, Buford, GA 30519 | 2017-06-08 |
| 1598158909 | Musik To Grow | Clinic/Center | 1517 Johnson Ferry Rd, Marietta, GA 30062-6493 | 2015-03-09 |
| 1356692800 | Ridgewood Personal Care Home, Inc | Clinic/Center | 1065 Murray Cir Sw, Marietta, GA 30064-3927 | 2012-09-24 |
| 1790055432 | Trapeze Therapy, LLC | Clinic/Center | 160 Tracy St, Suite A, Athens, GA 30601-1979 | 2012-01-11 |
| 1326316274 | Early/miller Day (now) | Clinic/Center | 302 Damacus Street, Blakely, GA 39823-3346 | 2011-12-07 |
| 1710255773 | Early Miller Personal Support (now) | Clinic/Center | 302 Damascus Street, Blakely, GA 39823-3346 | 2011-12-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.