Kristen Leadbetter, M.D.

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

036-134761 Issued in IL

Practice address

415 N 9TH St
Ste 4W16
Springfield, IL 62702-5303

Phone

(217) 545-8000

Fax

(217) 757-6844

NPI assigned

Jul 9, 2008

Last updated

Aug 12, 2014By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Siu Physicians & Surgeons, Inc

  dba SIU HealthCare

  • Endocrinology, Diabetes & Metabolism Physician
  • Springfield, IL
  • NPI 1558385989
  Medicare reassignment NPD
• Siu Physicians & Surgeons, Inc

  • Durable Medical Equipment & Medical Supplies
  • Springfield, IL
  • NPI 1164055976
  NPD
• Siu Physicians & Surgeons, Inc

  • Pediatrics Physician
  • Springfield, IL
  • NPI 1285657379
  NPD (past)

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407801600000",
    "number": "1083877088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19676",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949676",
            "telephone_number": "217-545-8000",
            "fax_number": "217-757-6844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N 9TH ST",
            "address_2": "STE 4W16",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025303",
            "telephone_number": "217-545-8000",
            "fax_number": "217-757-6844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEADBETTER",
        "first_name": "KRISTEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2014-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IL",
            "license": "036-134761",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-134761",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036134761",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caleb Joseph Lay, MD
• Sarah Cathrine Lazarski, NP
• Bang H Le, PHARMD
• Daphne Le, SLP
• Robert Leach
• Sarah Leaf, MD, RD, LDN
• Sydney K Lear, RBT
• Brett Donovan Leavey
• Wynn Jane Leber, MA
• Corwin-Daniel Oscar Leblanc, ATC

• Neonatal-Perinatal Medicine Physician in Springfield, IL
• Providers in Springfield, IL by specialty
• Neonatal-Perinatal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2014; 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.