Active NPI
Justin David Leavitt, MD
- Student in an Organized Health Care Education/Training Program
- Wilmington, NC
National Provider Identifier
1215566831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 261839
- Practice address
- 2131 S 17TH St
Wilmington, NC 28401-7407 - Phone
- (910) 343-7000
- Fax
- (910) 667-5650
- NPI assigned
- Apr 6, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 261839 | NC | Primary |
Addresses
Primary practice location
2131 S 17TH St
Wilmington, NC 28401-7407
Mailing address
2131 S 17TH St
Wilmington, NC 28401-7407
Phone (910) 343-7000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200630002405 | NC | Order and Referring Only - General Practice | 2163845660 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 261839 | NC | MD | Student in an Organized Health Care Education/Training Program |
Interoperability endpoints
- jleavitt1248442@direct.novanthealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586131200000",
"number": "1215566831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2131 S 17TH ST",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284017407",
"telephone_number": "910-343-7000",
"fax_number": "910-667-5650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2131 S 17TH ST",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284017407",
"telephone_number": "910-343-7000",
"fax_number": "910-667-5650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEAVITT",
"first_name": "JUSTIN",
"middle_name": "DAVID",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-06",
"last_updated": "2020-04-06",
"certification_date": "2020-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NC",
"license": "261839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
- Learning Perspectives, Inc.
- Learning Perspectives, Incorporated
- Learning Perspectives, Incorporated
- Learning Perspectives, Incorporated
- Learning Perspectives, Incorporated
- Joseph Albert Leblanc, LCSW, LCAS, CCAS
- Lecci Psychological Services, PLLC
- Lecci Psychological Services, PLLC
- Len B Lecci, PHD
- Lechris Health Systems of Wilmington, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.