Brooke Rachelle Leichty, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

002399 Issued in IA

Practice address

200 Hawkins Dr
Dept of Internal Medicine
Iowa City, IA 52242-1009

Phone

(319) 356-1758

Fax

(319) 353-6399

NPI assigned

Aug 25, 2010

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 names 1

• Brooke Rachelle Henderson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Missouri Emergency Services, P.C.

  • Emergency Medicine Physician
  • Pleasanton, CA
  • NPI 1134499049
  NPD (past)

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

{
    "created_epoch": "1282694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1093021347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "address_2": "DEPT OF INTERNAL MEDICINE",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-1758",
            "fax_number": "319-353-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "address_2": "DEPT OF INTERNAL MEDICINE",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-1758",
            "fax_number": "319-353-6399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEICHTY",
        "first_name": "BROOKE",
        "middle_name": "RACHELLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-25",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2010029429",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "002399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "HENDERSON",
            "middle_name": "RACHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Legacy Active Living Retirement Community
• Ryan Keegan Lehmann, D.O.
• Lauri Jo Lehn, PHD
• Alyssa Lehnen, ARNP
• Connor Leichtle, LAT, ATC
• Rebecca R Leidal, M.D.
• Grace Leidig
• Carolyn Leinenbach, RN
• Enrique C Leira, MD
• Lauren Katherine Leitner

• Physician Assistant in Iowa City, IA
• Providers in Iowa City, IA by specialty
• Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; 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.