Dwain Alan Leonhardt – Internal Medicine Physician

Key facts

NPI: 1497755474
Entity type: Individual (NPI type 1)
Primary specialty: Internal Medicine Physician 207R00000X
License: 19915 (NE)
Practice address: 4501 S 70TH St
Suite 130
Lincoln, NE 68516-4282
Phone: (402) 484-4940
NPI assigned: Jul 29, 2005
Sex: Male
Sole proprietor: No

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.

Downtown Physicians Group Family Medicine Physician · Lincoln, NE · NPI 1942270350

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
19915	NE	MD	Internal Medicine Physician

Practice roles

Organization	Specialty	Status	New patients
Downtown Physicians Group		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Internal Medicine Physician	207R00000X	19915	NE	Yes

Addresses

Primary practice location

4501 S 70TH St
Suite 130
Lincoln, NE 68516-4282

Mailing address

6530 S 66TH St
Lincoln, NE 68516-3691

Other identifiers

Identifier	Type	State	Issuer
30567	Other	NE	BCBS
47082189713	Medicaid	NE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 23, 2010.

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266883200000",
    "number": "1497755474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6530 S 66TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685163691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 S 70TH ST",
            "address_2": "SUITE 130",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685164282",
            "telephone_number": "402-484-4940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONHARDT",
        "first_name": "DWAIN",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2010-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "19915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "30567",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47082189713",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

All providers in Lincoln, NE · Internal Medicine Physician in Nebraska

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2010. 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.

Verify at the official NPI Registry.