Individual provider Active NPI

Berne M Leavitt Sr., PT

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1457343188
Registry record updated Nov 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
444 Issued in NV
Practice address
3831 W Charleston Blvd
Las Vegas, NV 89102-1859
Phone
(702) 876-1733
Fax
(702) 878-2018
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 444 NV Primary

Addresses

Primary practice location

3831 W Charleston Blvd
Las Vegas, NV 89102-1859

Mailing address

3831 W Charleston Blvd
Las Vegas, NV 89102-1859
Phone (702) 876-1733

Other identifiers 1

IdentifierTypeStateIssuer
100503692MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040813000865 NV Practitioner - Physical Therapist in Private Practice 0244203784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chynoweth Hill and Leavitt LLCGroup PAC ID 7012980550, 41 clinicians

Practice addresses (Care Compare)

3831 W Charleston Blvd
Las Vegas, NV 89102-1859
Phone (702) 876-1733

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0444NVMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chynoweth Hill and Leavitt LLC Physical Therapist CurrentSince Jul 12, 2004 Accepting new patients
Chynoweth Hill and Leavitt LLC CurrentSince Jul 12, 2004 Accepting new patients

Locations

375 N Stephanie St
Ste 1111
Henderson, NV 89014
Phone (702) 456-2024

3831 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 876-1733

921 S Nevada Highway 160
Ste 409
Pahrump, NV 89048
Phone (775) 727-3838

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195430400000",
    "number": "1457343188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3831 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021859",
            "telephone_number": "702-876-1733",
            "fax_number": "702-878-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3831 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021859",
            "telephone_number": "702-876-1733",
            "fax_number": "702-878-2018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAVITT",
        "first_name": "BERNE",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2007-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100503692",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; 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.

Verify at the official NPI Registry.