Kenneth Tyler Leaphart, PA-C is a medicare enrolled "Physician Assistant" physician in Greensboro, North Carolina. His current practice location is
1200 N Elm St, Greensboro, North Carolina. You can reach out to his office (for appointments etc.) via phone at
(336) 207-7005.
Kenneth Tyler Leaphart is licensed to practice in North Carolina (license number 0010-07324) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1699295543.
Physician's Profile
| Full Name | Kenneth Tyler Leaphart |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Location | 1200 N Elm St, Greensboro, North Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1699295543
- Provider Enumeration Date: 06/21/2017
- Last Update Date: 07/11/2023
Medicare PECOS Information:
- PECOS PAC ID: 1153694393
- Enrollment ID: I20170908002891
Medical Identifiers
Medical identifiers for Kenneth Tyler Leaphart such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1699295543 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207PE0004X | Emergency Medicine - Emergency Medical Services | 001007324 (North Carolina) | Secondary |
| 363A00000X | Physician Assistant | 0010-07324 (North Carolina) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kenneth Tyler Leaphart is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Kenneth Tyler Leaphart, PA-C 123 Piedmont Ave Apt D, Winston Salem, NC 27101-3667 Ph: (803) 760-0859 | Kenneth Tyler Leaphart, PA-C 1200 N Elm St, Greensboro, NC 27401-1004 Ph: (336) 207-7005 |
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