Active NPI
Blair Alan Leavitt, PA-C
- Physician Assistant
- Rome, GA
National Provider Identifier
1093141145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 006927
- Practice address
- 330 Turner McCall Blvd SW
Rome, GA 30165-5630 - Phone
- (706) 236-6426
- Fax
- (706) 236-6437
- NPI assigned
- Sep 20, 2013
- Last updated
- Sep 20, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 006927 | GA | Primary |
Addresses
Primary practice location
330 Turner McCall Blvd SW
Rome, GA 30165-5630
Mailing address
1825 Martha Berry Blvd NW
Rome, GA 30165-1625
Phone (706) 295-5331
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harbin Clinic, LLC | Current | Accepting new patients |
Locations
1825 Martha Berry Blvd NW
Rome, GA 30165
Phone (706) 238-8073
330 Turner McCall Blvd SW
Rome, GA 30165
Phone (706) 802-2000
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379635200000",
"number": "1093141145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1825 MARTHA BERRY BLVD NW",
"city": "ROME",
"state": "GA",
"postal_code": "301651625",
"telephone_number": "706-295-5331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 TURNER MCCALL BLVD SW",
"city": "ROME",
"state": "GA",
"postal_code": "301655630",
"telephone_number": "706-236-6426",
"fax_number": "706-236-6437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEAVITT",
"first_name": "BLAIR",
"middle_name": "ALAN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-09-20",
"last_updated": "2013-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "006927",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rome, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.