Active NPI
Marvin E Leedy, MD
- Ophthalmology Physician
- Barberton, OH
National Provider Identifier
1003893124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 35032575L
- Practice address
- 31 Conservatory Dr
Barberton, OH 44203-4281 - Phone
- (330) 753-7523
- Fax
- (330) 753-9162
- NPI assigned
- Dec 29, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 35032575L | OH | Primary |
Addresses
Primary practice location
31 Conservatory Dr
Barberton, OH 44203-4281
Mailing address
31 Conservatory Dr
Barberton, OH 44203-4281
Phone (330) 753-7523
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000131917 | Other | OH | ANTHEM |
| 0800639 | Other | OH | CIGNA |
| 1058 | Other | OH | HOMETOWN |
| 0455010 | Medicaid | OH | |
| 0800722 | Other | OH | UNITED FOOD COMMERCIAL |
| 0800723 | Other | OH | AETNA |
| 0800638 | Other | OH | UNITED HEALTHCARE |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35032575L | OH | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307923200000",
"number": "1003893124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 CONSERVATORY DR",
"city": "BARBERTON",
"state": "OH",
"postal_code": "442034281",
"telephone_number": "330-753-7523",
"fax_number": "330-753-9162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31 CONSERVATORY DR",
"city": "BARBERTON",
"state": "OH",
"postal_code": "442034281",
"telephone_number": "330-753-7523",
"fax_number": "330-753-9162"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEEDY",
"first_name": "MARVIN",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-29",
"last_updated": "2011-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "OH",
"license": "35032575L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000131917",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "0800639",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HOMETOWN",
"identifier": "1058",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0455010",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED FOOD COMMERCIAL",
"identifier": "0800722",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0800723",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "0800638",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Barberton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.