Walter Clifford Leibold, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

WL041417 Issued in MI

Practice address

2106 S Gray Rd
West Branch, MI 48661-9606

Phone

(989) 345-7880

Fax

(989) 345-7882

NPI assigned

Oct 31, 2006

Last updated

Jun 19, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ogemaw Hills Community of Caring

  • Primary Care Clinic/Center
  • West Branch, MI
  • NPI 1497532642
  NPD (past)

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403136000000",
    "number": "1316023526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 S GRAY RD",
            "city": "WEST BRANCH",
            "state": "MI",
            "postal_code": "486619606",
            "telephone_number": "989-345-7880",
            "fax_number": "989-345-7882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 S GRAY RD",
            "city": "WEST BRANCH",
            "state": "MI",
            "postal_code": "486619606",
            "telephone_number": "989-345-7880",
            "fax_number": "989-345-7882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIBOLD",
        "first_name": "WALTER",
        "middle_name": "CLIFFORD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2014-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "WL041417",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301041417",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2125588",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vijay Kumar, PT,PHD
• Rachel Laszko, MD
• Selena Lazo
• Leelin Home Health Care, Inc
• Leelin Home Health Care, Inc
• Lesley Lynn Lenahan Finkbeiner
• Gregory Lester
• Mark DJ Lewandowski, DDS
• Trey Lewandowski, DDS
• Crystal Ann Lewis

• Surgery Physician in West Branch, MI
• Providers in West Branch, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; 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.

Verify at the official NPI Registry.