Leon Jacob Bogartz, M.D.,
Individual provider Active NPI Specialist · Powell, TN
NPI 1477583268 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1477583268
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 0000006741 (TN)
- Practice address
- 7540 Dannaher LN
Ste. 300
Powell, TN 37849-4013 - Phone
- (865) 362-8524
- Fax
- (865) 545-3115
- NPI assigned
- Jul 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000006741 | TN | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sleep Associates of East Tennessee PLLC | Past | Accepting new patients | |
| Tranquility Sleep Specialists PLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 0000006741 | TN | Yes |
Addresses
Primary practice location
7540 Dannaher LN
Ste. 300
Powell, TN 37849-4013
Mailing address
2 Woodstock CT
Hilton Head, SC 29928-3385
Phone (843) 842-7875
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2002856 | Medicaid | TN |
Other providers in Powell, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.