Individual provider Active NPI

Megan Marissa Martin-Leitzen, PHARM.D.

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Marion, IL
National Provider Identifier
1558678748
Registry record updated Sep 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
051289401 Issued in IL
Practice address
2401 W Main St
Marion, IL 62959-1188
Phone
(618) 997-5311
NPI assigned
Sep 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 051289401 IL Primary

Addresses

Primary practice location

2401 W Main St
Marion, IL 62959-1188

Mailing address

2401 W Main St
Marion, IL 62959-1188
Phone (618) 997-5311

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
051289401ILMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283990400000",
    "number": "1558678748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W MAIN ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629591188",
            "telephone_number": "618-997-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W MAIN ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629591188",
            "telephone_number": "618-997-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN-LEITZEN",
        "first_name": "MEGAN",
        "middle_name": "MARISSA",
        "name_prefix": "Mrs.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-09",
        "last_updated": "2010-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "IL",
            "license": "051289401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.