Active NPI
Leia Christine Ritt, ATC
- Athletic Trainer
- Cottage Grove, MN
National Provider Identifier
1407293368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1857
- Practice address
- 8040 80TH St S
Cottage Grove, MN 55016-2052 - Phone
- (651) 768-5767
- NPI assigned
- May 31, 2013
- Last updated
- May 31, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 1857 | MN | Primary |
Addresses
Primary practice location
8040 80TH St S
Cottage Grove, MN 55016-2052
Mailing address
1508 Dixon Dr
St Paul Park, MN 55071-1235
Phone (651) 470-1549
Other names 1
- Leia Christine Van Booven
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1857 | MN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369958400000",
"number": "1407293368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1508 DIXON DR",
"city": "ST PAUL PARK",
"state": "MN",
"postal_code": "550711235",
"telephone_number": "651-470-1549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8040 80TH ST S",
"city": "COTTAGE GROVE",
"state": "MN",
"postal_code": "550162052",
"telephone_number": "651-768-5767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RITT",
"first_name": "LEIA",
"middle_name": "CHRISTINE",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-31",
"last_updated": "2013-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MN",
"license": "1857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LEIA",
"last_name": "VAN BOOVEN",
"middle_name": "CHRISTINE",
"credential": "ATC",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Cottage Grove, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.