Edwin Lockwood Leavitt, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C0001832 Issued in MD

Practice address

2257 Huber Road
Fort Meade, MD 20755-5378

Phone

(443) 845-6295

Fax

(301) 677-7149

NPI assigned

May 2, 2007

Sex

Male

Sole proprietor

No

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)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265653596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2043 RIVER DOWNS CT",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210503142",
            "telephone_number": "443-845-6295",
            "fax_number": "301-677-7149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2257 HUBER ROAD",
            "city": "FORT MEADE",
            "state": "MD",
            "postal_code": "207555378",
            "telephone_number": "443-845-6295",
            "fax_number": "301-677-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAVITT",
        "first_name": "EDWIN",
        "middle_name": "LOCKWOOD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0001832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John T Koehler, O.D.
• Riley Konara, MD
• Christina Marie Koreerat, DPT
• Kate Sands Kramer, RN
• Lisa Oh Laurel, PHARM D
• Leigh Anne Lechanski, DPT
• Charles Churlmin Lee, MD
• Christopher Sien Lee, M.D.
• Janet Yvonne Lee, FAMILY NURSE PRACTIT
• Jaclyn Leith, PH.D.

• Physician Assistant in Fort Meade, MD
• Providers in Fort Meade, MD by specialty
• Physician Assistant in Maryland

• 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.