Individual provider Active NPI

Ethan Leabhart, DO

  • Psychiatry Physician
  • Hickory, NC
National Provider Identifier
1124607577
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2025-00920 Issued in NC
Practice address
1120 Fairgrove Church Rd Ste 12
Hickory, NC 28602-9630
Phone
(828) 326-2828
NPI assigned
Apr 5, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2025-00920 NC Primary

Addresses

Primary practice location

1120 Fairgrove Church Rd Ste 12
Hickory, NC 28602-9630

Mailing address

810 Fairgrove Church Rd
Hickory, NC 28602-9617

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20250730002650 NC Practitioner - Psychiatry 1052828324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
West Virginia School of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catawba Valley Medical Center 105 clinicians

Practice addresses (Care Compare)

1120 Fairgrove Church Rd
Suite 12
Hickory, NC 28602-9630
Phone (828) 326-2828

Hospital & facility affiliations

  • Catawba Valley Medical Center Hospital, Hickory, NC, CCN 340143

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Catawba Valley Medical Center CurrentSince Jul 28, 2025 Accepting new patients
Catawba Valley Medical Center Psychiatry CurrentSince Jul 28, 2025 Accepting new patients

Locations

1120 Fairgrove Church Rd
Ste 12
Hickory, NC 28602
Phone (828) 326-2828

810 Fairgrove Church Rd
Hickory, NC 28602
Phone (704) 326-3000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EJDFAA/Endpoint/EJDFAA

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1124607577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 FAIRGROVE CHURCH RD",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286029617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 FAIRGROVE CHURCH RD STE 12",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286029630",
            "telephone_number": "828-326-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEABHART",
        "first_name": "ETHAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-05",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2025-00920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.