Individual provider Active NPI

Antoinette Josephine Leggitt

  • Specialist
  • Mayer, AZ
National Provider Identifier
1164582250
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
17441 Trail End Road
Mayer, AZ 86333
Phone
(928) 632-4857
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

17441 Trail End Road
Mayer, AZ 86333

Mailing address

17441 Trail End Road
Mayer, AZ 86333
Phone (928) 632-4857

Other identifiers 1

IdentifierTypeStateIssuer
AHCCCSOtherAZSTATE OF AZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164582250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17441 TRAIL END ROAD",
            "city": "MAYER",
            "state": "AZ",
            "postal_code": "86333",
            "telephone_number": "928-632-4857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17441 TRAIL END ROAD",
            "city": "MAYER",
            "state": "AZ",
            "postal_code": "86333",
            "telephone_number": "928-632-4857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGGITT",
        "first_name": "ANTOINETTE",
        "middle_name": "JOSEPHINE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF AZ",
            "identifier": "AHCCCS",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayer, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.