Organization Active NPI

Leatherwood Family Enterprises

  • Family Medicine Physician
  • Las Cruces, NM
National Provider Identifier
1538333109
Registry record updated Feb 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD2006-0321 Issued in NM
Legal business name
LEATHERWOOD FAMILY ENTERPRISES
Practice address
4351 E Lohman Ave Ste 405
Las Cruces, NM 88011-8261
Phone
(575) 522-0091
Fax
(575) 522-4984
NPI assigned
Apr 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2010

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

Authorized official

Name
Dr. Mark Leatherwood, M.D.
Title
Owner
Phone
(575) 522-0091

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X MD2006-0321 NM Primary

Addresses

Primary practice location

4351 E Lohman Ave Ste 405
Las Cruces, NM 88011-8261

Mailing address

4351 E Lohman Ave Ste 405
Las Cruces, NM 88011-8261
Phone (575) 522-0091

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265328000000",
    "number": "1538333109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4351 E LOHMAN AVE STE 405",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118261",
            "telephone_number": "575-522-0091",
            "fax_number": "575-522-4984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4351 E LOHMAN AVE STE 405",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118261",
            "telephone_number": "575-522-0091",
            "fax_number": "575-522-4984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEATHERWOOD FAMILY ENTERPRISES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2010-02-05",
        "status": "A",
        "authorized_official_last_name": "LEATHERWOOD",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-522-0091",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2006-0321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.