David John Leandro, C.PED

Primary specialty

ContractorTaxonomy code 171W00000X

License

9914 Issued in GA

Practice address

4760 Lawrenceville Hwy NW
Suite C-1
Lilburn, GA 30047-3858

Phone

(770) 921-4480

Fax

(678) 205-1738

NPI assigned

Jun 27, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Lilburn Shoe Repair & Pedorthics Inc

  • Durable Medical Equipment & Medical Supplies
  • Lilburn, GA
  • NPI 1063564367
  NPD

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053317867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4814 DELGADO DR SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300475204",
            "telephone_number": "770-931-0823",
            "fax_number": "678-205-1738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 LAWRENCEVILLE HWY NW",
            "address_2": "SUITE C-1",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473858",
            "telephone_number": "770-921-4480",
            "fax_number": "678-205-1738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEANDRO",
        "first_name": "DAVID",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "C.PED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "GA",
            "license": "9914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER PERMANENTE",
            "identifier": "L937",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Empris Lavant
• Cassie Lawrence, PTA
• Bryant Tao Le, DC
• Thai Thong Le, FNP-BC
• Veronica Joye Leader
• Lynn D. Leandro, GNP-BC
• Yahaira Ledgister
• Cheryl Lee, D.C,
• Jina Lee
• Sara Diamond Lee, PHARMD

• Contractor in Lilburn, GA
• Providers in Lilburn, GA by specialty
• Contractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.