Susan G. Leavenworth, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1095 Issued in KY

Practice address

6450 Dutchmans Pkwy
Louisville, KY 40205-3338

Phone

(502) 895-9900

Fax

(502) 895-9901

NPI assigned

Jun 15, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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

• Retina and Vitreous Associates of Kentucky PLLC

  • Retina Specialist (Ophthalmology) Physician
  • Lexington, KY
  • NPI 1619949971
  NPD (past)

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376748814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6450 DUTCHMANS PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402053338",
            "telephone_number": "502-895-9900",
            "fax_number": "502-895-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6450 DUTCHMANS PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402053338",
            "telephone_number": "502-895-9900",
            "fax_number": "502-895-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAVENWORTH",
        "first_name": "SUSAN",
        "middle_name": "G.",
        "name_prefix": "Ms.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KY",
            "license": "1095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11351412",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah O Leasure, PA-C
• Melissa Anne Leath, PHD
• Brooke Leatherman, MOT, OTR/L
• Darla C Leavell, CRNA
• Tomeika Shondale Leavell, LCSW
• Katherine Rae Leaver, APRN
• Aaron Louis Leavitt, PHARMD, MBA
• Linda Leavitt
• Rebecca Meredith Leavitt, MD
• Stephen Patrick Lebder, MD

• Psychologist in Louisville, KY
• Providers in Louisville, KY by specialty
• Psychologist in Kentucky

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.