Peter John Leichtnam

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Practice address

1200 W Ironwood Dr Ste 309
Coeur D Alene, ID 83814-2660

Phone

(509) 994-2105

NPI assigned

Sep 12, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• American Mobile Drug Testing / a Drug Free Alliance

  • Clinic/Center
  • Coeur D Alene, ID
  • NPI 1952951329
  NPD Authorized official

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1164072187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W IRONWOOD DR STE 309",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142660",
            "telephone_number": "509-994-2105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W IRONWOOD DR STE 309",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142660",
            "telephone_number": "509-994-2105"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10905 E Montgomery Dr Ste 4",
            "address_purpose": "LOCATION",
            "city": "Spokane Valley",
            "state": "WA",
            "postal_code": "992066606",
            "country_code": "US",
            "telephone_number": "509-994-2105",
            "fax_number": "509-892-6924",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10905 E Montgomery Dr Ste 4",
            "address_purpose": "LOCATION",
            "city": "Spokane Valley",
            "state": "WA",
            "postal_code": "992066606",
            "country_code": "US",
            "telephone_number": "509-994-2105",
            "fax_number": "509-892-6924",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 W Ironwood Dr Ste 309",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838142660",
            "country_code": "US",
            "telephone_number": "509-994-2105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEICHTNAM",
        "first_name": "PETER",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-12",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Starr K Lee
• Robert Everett Leeth, FNP, PMHNP
• Legends Park Community Healthcare LLC
• Legends Park LLC
• Hannah Jean Lehrsch, LM, CPM
• Jud Eugene Leifheit, LCSW
• Tori Christine Lennox
• Leonard D. Guth MD PC
• Joshua Leppert, CRNA
• Robert J Leppert, CRNA

• Clinic/Center in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.