Individual provider Active NPI

Ryan Leonberger, NP

  • Nurse Practitioner
  • Marion, IL
National Provider Identifier
1134068240
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.035238 Issued in IL
Practice address
3329 W Deyoung St
Marion, IL 62959-5884
Phone
(618) 997-2161
Fax
(618) 998-2420
NPI assigned
Mar 25, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.035238 IL Primary

Addresses

Primary practice location

3329 W Deyoung St
Marion, IL 62959-5884

Mailing address

PO Box 632330
Cincinnati, OH 45263-2330
Phone (812) 450-6815

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260604000782 IL Practitioner - Nurse Practitioner 0648741207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

190 Doc Rd
Eldorado, IL 62930-3544

200 Corporate Blvd
Lafayette, LA 70508-3844

500 W Jefferson St
Louisville, KY 40202-2823

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.035238ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Illinois Clinic, Inc Nurse Practitioner PastSince May 4, 2025 Accepting new patients
Deaconess Illinois Clinic, Inc Nurse Practitioner Past Accepting new patients

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": "1774396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1134068240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632330",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632330",
            "telephone_number": "812-450-6815",
            "fax_number": "812-450-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3329 W DEYOUNG ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595884",
            "telephone_number": "618-997-2161",
            "fax_number": "618-998-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONBERGER",
        "first_name": "RYAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-25",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.035238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

Verify at the official NPI Registry.