Individual provider Active NPI

Leanne Mihata, M.D.

  • Pediatrics Physician
  • Birmingham, AL
National Provider Identifier
1376835496
Registry record updated Jan 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD.34423 Issued in AL
Practice address
500 Cahaba Park Cir Ste 100
Birmingham, AL 35242-8136
Phone
(205) 848-2273
Fax
(205) 848-2275
NPI assigned
May 8, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101234585 VA
Pediatrics Physician 208000000X 036.127903 IL
Pediatrics Physician 208000000X 35097934 OH
Pediatrics Physician 208000000X MD.34423 AL Primary

Addresses

Primary practice location

500 Cahaba Park Cir Ste 100
Birmingham, AL 35242-8136

Mailing address

1640 N Limestone St
Springfield, OH 45503
Phone (937) 328-2320

Other identifiers 1

IdentifierTypeStateIssuer
0053078MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180720000917 AL Practitioner - Pediatric Medicine 1355698465 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.127903ILMDPediatrics Physician
35097934OHMDPediatrics Physician
0101234585VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Urgent Care, LLC Pediatrics CurrentSince Dec 26, 2017 Accepting new patients
Pediatric Associates of Springfield Inc Pediatrics Past Accepting new patients

Locations

500 Cahaba Park Cir
Ste 100
Birmingham, AL 35242
Phone (205) 848-2273

117 N Chalkville Rd
Trussville, AL 35173
Phone (205) 848-2273

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1304812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516579200000",
    "number": "1376835496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 N LIMESTONE ST",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "45503",
            "telephone_number": "937-328-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CAHABA PARK CIR STE 100",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352428136",
            "telephone_number": "205-848-2273",
            "fax_number": "205-848-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIHATA",
        "first_name": "LEANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-08",
        "last_updated": "2018-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101234585",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.127903",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35097934",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "MD.34423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0053078",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.