Individual provider Active NPI

Garth Renton Leadbetter, RN

  • Pediatric Registered Nurse
  • Centennial, CO
National Provider Identifier
1194238485
Registry record updated Nov 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
RN.1622618 Issued in CO
Practice address
304 Inverness Way S Ste 125
Centennial, CO 80112-5820
Phone
(303) 759-1342
NPI assigned
Nov 9, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X RN.1622618 CO Primary

Addresses

Primary practice location

304 Inverness Way S Ste 125
Centennial, CO 80112-5820

Mailing address

686 S High St
Denver, CO 80209-4527
Phone (303) 744-6688

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN.1622618COMDPediatric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510185600000",
    "number": "1194238485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "686 S HIGH ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802094527",
            "telephone_number": "303-744-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 INVERNESS WAY S STE 125",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801125820",
            "telephone_number": "303-759-1342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEADBETTER",
        "first_name": "GARTH",
        "middle_name": "RENTON",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-09",
        "last_updated": "2017-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "CO",
            "license": "RN.1622618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2017; 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.