John Leonard, MD
Individual provider Active NPI Emergency Medicine Physician · Live Oak, TX
NPI 1154741155 · NPPES record last updated Oct 16, 2018
Key facts
- NPI
- 1154741155
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- R3706 (TX)
- Practice address
- 12412 Judson Rd
Live Oak, TX 78233-3255 - Phone
- (210) 757-7000
- NPI assigned
- Apr 17, 2014
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200110001120 | IL | Practitioner - Emergency Medicine | 1759689318 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rockford Health Physicians | Current |
Accepting new patients |
Locations
29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652
2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310
2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | R3706 | TX | Yes |
Addresses
Primary practice location
12412 Judson Rd
Live Oak, TX 78233-3255
Mailing address
801 W 5TH St Apt 1001
Austin, TX 78703-5456
Phone (815) 703-7284
Other practice location 1
1501 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 675-6632
Other providers in Live Oak, TX
- Jennifer Lankford
- Cynthia Leboeuf
- Christiann Trinette Ledford
- Janeth Lee
- Legacy Heart Care of San Antonio
- Michael Levi
- Angelica Lightfoot
- Justin Linam
- David Liu
- Nadine Liu
All providers in Live Oak, TX · Emergency Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.