Leestma Medical Clinic, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02000641A Issued in IN

Legal business name

LEESTMA MEDICAL CLINIC, INC

Practice address

519 N Halleck St
Demotte, IN 46310-9553

Phone

(219) 987-7750

Fax

(219) 987-5750

NPI assigned

Feb 2, 2010

Last updated

May 4, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Eric J Leestma, D.O.NPI 1700989233

Title

President

Phone

(219) 987-7750

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21537/brand/1/csg/1/fhir/r4

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eric J Leestma

  • Family Medicine Physician
  • Demotte, IN
  • NPI 1700989233
  Medicare reassignment Care Compare group Authorized official
• Micah James Leestma, D.O.

  • Family Medicine Physician
  • Demotte, IN
  • NPI 1013201623
  Medicare reassignment Care Compare group NPD
• Adam Leestma, FNP

  • Family Nurse Practitioner
  • Demotte, IN
  • NPI 1891230140
  Medicare reassignment Care Compare group
• Mallory Nichole Matusik, FNP

  • Family Nurse Practitioner
  • Demotte, IN
  • NPI 1386379501
  NPD
• Morganne Atteberry, FNP

  • Nurse Practitioner
  • Demotte, IN
  • NPI 1376280073
  NPD (past)
• Arsenio Santiago Favor, M.D.

  • Surgery Physician
  • Demotte, IN
  • NPI 1104867068
  NPD (past)
• Scott N Keith, DPM

  • Foot Surgery Podiatrist
  • Crown Point, IN
  • NPI 1972606184
  NPD (past)
• Stephany Sipe, NP-C

  • Nurse Practitioner
  • Demotte, IN
  • NPI 1336537026
  NPD (past)
• Frances Jean Smith, FNP

  • Family Nurse Practitioner
  • Demotte, IN
  • NPI 1720113160
  NPD (past)
• Stephanie Michelle Walker, FNP-C

  • Family Nurse Practitioner
  • Crown Point, IN
  • NPI 1235911066
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1265068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272931200000",
    "number": "1487986451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850",
            "city": "DEMOTTE",
            "state": "IN",
            "postal_code": "463100850",
            "telephone_number": "219-987-7750",
            "fax_number": "219-987-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 N HALLECK ST",
            "city": "DEMOTTE",
            "state": "IN",
            "postal_code": "463109553",
            "telephone_number": "219-987-7750",
            "fax_number": "219-987-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEESTMA MEDICAL CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-02",
        "last_updated": "2010-05-04",
        "status": "A",
        "authorized_official_last_name": "LEESTMA",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-987-7750",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02000641A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adam Leestma, FNP
• Eric J Leestma
• Micah James Leestma, D.O.
• Cheryle Rae Lewandowski, PTA
• Little Green Thumbs ABA LLC

• Family Medicine Physician in Demotte, IN
• Providers in Demotte, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.

Verify at the official NPI Registry.