Leann G Bach, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10004060 Issued in WA

Practice address

601 W 5TH Ave
Suite 400
Spokane, WA 99204-2715

Phone

(509) 344-2663

Fax

(509) 624-9179

NPI assigned

Aug 11, 2005

Last updated

Sep 21, 2015By the provider in NPPES

Sex

Female

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 3

Other names 1

• Leann Greene Former name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Deer Park Family Care Clinic PS

  dba Deer Park Family Care Clinic

  • Family Medicine Physician
  • Deer Park, WA
  • NPI 1548294150
  Medicare reassignment

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1063414878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414N VERCLER RD 4",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161092",
            "telephone_number": "509-924-4681",
            "fax_number": "509-922-7634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W 5TH AVE",
            "address_2": "SUITE 400",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042715",
            "telephone_number": "509-344-2663",
            "fax_number": "509-624-9179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACH",
        "first_name": "LEANN",
        "middle_name": "G",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-11",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID OTHER",
            "identifier": "806048900",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASURIS NW HEALTH",
            "identifier": "6016BA",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8329666",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEANN",
            "last_name": "GREENE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tiana Pualani Babers
• Anastasia Reign Babnick
• Jacqueline Mendoza Babol, DPM
• David Allen Baca, PA-C
• Krista Hillary Baca, CRNA
• Erica Leigh Bachand, DPT
• Bijou Bachelor
• Brad James Bachmeier, PA-C
• Back in Motion, P.S.
• Samantha Back

• Physician Assistant in Spokane, WA
• Providers in Spokane, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.