Active NPI
Douglas Shaffer Leonard, M.A.
- Audiologist
- Atlantic, IA
National Provider Identifier
1447348784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 00473
- Practice address
- 601 Poplar St
Atlantic, IA 50022-1448 - Phone
- (712) 243-5793
- Fax
- (712) 243-5796
- NPI assigned
- Oct 11, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 00473 | IA | Primary |
Addresses
Primary practice location
601 Poplar St
Atlantic, IA 50022-1448
Mailing address
601 Poplar St
Atlantic, IA 50022-1448
Phone (712) 243-5793
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0421206 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
601 Poplar St
Atlantic, IA 50022-1448
Phone (712) 243-5796
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
Organizations & group practices 1
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.
-
- Audiologist
- Atlantic, IA
- NPI 1417255878
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289433600000",
"number": "1447348784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 POPLAR ST",
"city": "ATLANTIC",
"state": "IA",
"postal_code": "500221448",
"telephone_number": "712-243-5793",
"fax_number": "712-243-5796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 POPLAR ST",
"city": "ATLANTIC",
"state": "IA",
"postal_code": "500221448",
"telephone_number": "712-243-5793",
"fax_number": "712-243-5796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEONARD",
"first_name": "DOUGLAS",
"middle_name": "SHAFFER",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-11",
"last_updated": "2010-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "IA",
"license": "00473",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0421206",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Atlantic, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.