MRS. JACQUELYN M LEAK-GILLISPIE (NP-C) – Adult Health Nurse Practitioner, NPI 1831255330
Adult Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
10,248 NURSE PRACTITIONER in NC
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Provider Addresses for MRS. JACQUELYN M LEAK-GILLISPIE (NP-C)
Scott Nixon Memorial Drive, Foxhall, Augusta, Richmond County, Georgia, 30907, United States
AUGUSTA, GA 309072464
Phone: (800) 394-4445
Fax: (706) 650-1034
Type: Mailing
Carolinas HealthCare System NorthEast, 920, Church Street North, Concord, Cabarrus County, North Carolina, 28025, United States
CONCORD, NC 280252927
Phone: (704) 403-1430
Fax: (704) 403-1158
Type: Location
1085 NE Gateway Ct NE
Concord, NC 280252406
Phone: (704) 403-2525
Type: Location
PO BOX 2000
CONCORD, NC 280262000
Phone: (704) 403-1430
Fax: (704) 403-1158
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $77.
Total Amount is formed as General ($77) + Research ($0) + Ownership ($0) = $77.
Last reported payment date: 2024-12-07 • Largest payer in this snapshot: SPR Therapeutics, Inc ($77).
Total Amount
$77
General + Research + Ownership
Payments
1
Total payment records
General Amount
$77
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| SPR Therapeutics, Inc | $77 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2007-03-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20070312000406 | I | Nurse Practitioner | NC | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 350 | 129 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 33 | 33 | $0 |
Insurance plans in this area (ZIP 30907)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Occupational Therapist In Private Practice | NC | |
| Physician Assistant | SC | |
| Physical Therapist In Private Practice | NC | |
| Physical Therapist In Private Practice | NC | |
| G A S T R O E N T E R O L O G Y | NC | |
| Physical Therapist In Private Practice | SC | |
| Physical Therapist In Private Practice | NC | |
| Physical Therapist In Private Practice | TX | |
| Nurse Practitioner | NC | |
| Internal Medicine, Gastroenterology | NC |
Reviews
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