Individual provider Active NPI

Gregory S. Leet, O.D.

  • Optometrist
  • Cape Girardeau, MO
National Provider Identifier
1023182540
Registry record updated Sep 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T02586 Issued in MO
Practice address
3230 Blattner Dr.
Cape Girardeau, MO 63703-6380
Phone
(573) 334-2020
Fax
(573) 334-2915
NPI assigned
Nov 17, 2006
Last updated
Sep 13, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T02586 MO Primary
Optometrist 152W00000X 6483T TX

Addresses

Primary practice location

3230 Blattner Dr.
Cape Girardeau, MO 63703-6380

Mailing address

3230 Blattner Dr.
Cape Girardeau, MO 63703-6380
Phone (573) 334-2020

Other identifiers 1

IdentifierTypeStateIssuer
312069602MedicaidMO

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee Vision Partners PLLC Optometrist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1023182540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 BLATTNER DR.",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637036380",
            "telephone_number": "573-334-2020",
            "fax_number": "573-334-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3230 BLATTNER DR.",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637036380",
            "telephone_number": "573-334-2020",
            "fax_number": "573-334-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEET",
        "first_name": "GREGORY",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02586",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6483T",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "312069602",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.