Individual provider Active NPI

Daniel Ferrin Leavitt, MD

  • Family Medicine Physician
  • Red Bluff, CA
National Provider Identifier
1104160415
Registry record updated Sep 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C172218 Issued in CA
Practice address
2450 Sister Mary Columba Dr
Red Bluff, CA 96080-4356
Phone
(530) 527-0414
Fax
(530) 528-9329
NPI assigned
Nov 27, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C172218 CA Primary

Addresses

Primary practice location

2450 Sister Mary Columba Dr
Red Bluff, CA 96080-4356

Mailing address

2450 Sister Mary Columba Dr
Red Bluff, CA 96080-4356
Phone (530) 527-0414

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20210426000008 CA Order and Referring Only - Family PracticePractitioner - Family Practice 6305162199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C172218CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Past Accepting new patients
Dignity Health Past Accepting new patients
Catholic Healthcare West Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: daniel.leavitt.1@10692.direct.athenahealth.com

Organizations & group practices 3

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": "1353974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631318400000",
    "number": "1104160415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 SISTER MARY COLUMBA DR",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960804356",
            "telephone_number": "530-527-0414",
            "fax_number": "530-528-7923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 SISTER MARY COLUMBA DR",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960804356",
            "telephone_number": "530-527-0414",
            "fax_number": "530-528-9329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAVITT",
        "first_name": "DANIEL",
        "middle_name": "FERRIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-27",
        "last_updated": "2021-09-11",
        "certification_date": "2021-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C172218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bluff, CA

Sources for this page

Verify at the official NPI Registry.