Individual provider Active NPI

Ron J. Leavitt, AU.D.

  • Audiologist
  • Corvallis, OR
National Provider Identifier
1053430397
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
20698 Issued in OR
Practice address
975 NW Spruce Ave Ste 102
Corvallis, OR 97330-2297
Phone
(541) 754-1377
Fax
(541) 754-9192
NPI assigned
Mar 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 20698 OR Primary
Audiologist-Hearing Aid Fitter 237600000X 20698 OR

Addresses

Primary practice location

975 NW Spruce Ave Ste 102
Corvallis, OR 97330-2297

Mailing address

475 I St
Independence, OR 97351-1820
Phone (503) 838-2838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070831000106 OR Practitioner - Qualified Audiologist 0143313510 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20698ORMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Hearing Assistance Technology, Inc. Audiologist CurrentSince Jan 15, 2007 Accepting new patients

Locations

975 NW Spruce Ave
Ste 102
Corvallis, OR 97330
Phone (541) 738-8727

1025 NW 9th St
Ste D
Corvallis, OR 97330
Phone (541) 754-1377

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1053430397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 I ST",
            "city": "INDEPENDENCE",
            "state": "OR",
            "postal_code": "973511820",
            "telephone_number": "503-838-2838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 NW SPRUCE AVE STE 102",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973302297",
            "telephone_number": "541-754-1377",
            "fax_number": "541-754-9192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAVITT",
        "first_name": "RON",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OR",
            "license": "20698",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "OR",
            "license": "20698",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.