Active NPI
John S Ledbetter, MD
- Urology Physician
- Beverly, MA
National Provider Identifier
1437170263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 54518
- Practice address
- 75 Herrick St
Ste 219
Beverly, MA 01915 - Phone
- (978) 927-0714
- Fax
- (978) 927-9135
- NPI assigned
- Jul 21, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | 54518 | MA | Primary |
Addresses
Primary practice location
75 Herrick St
Ste 219
Beverly, MA 01915
Mailing address
75 Herrick St
Ste 219
Beverly, MA 01915
Phone (978) 927-0714
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3003418 | Medicaid | MA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428969600000",
"number": "1437170263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 HERRICK ST",
"address_2": "STE 219",
"city": "BEVERLY",
"state": "MA",
"postal_code": "01915",
"telephone_number": "978-927-0714",
"fax_number": "978-927-9135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 HERRICK ST",
"address_2": "STE 219",
"city": "BEVERLY",
"state": "MA",
"postal_code": "01915",
"telephone_number": "978-927-0714",
"fax_number": "978-927-9135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEDBETTER",
"first_name": "JOHN",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-21",
"last_updated": "2015-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "MA",
"license": "54518",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3003418",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beverly, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.