Individual provider Active NPI

Bart William Leavens, D.C.

  • Chiropractor
  • Clinton, IA
National Provider Identifier
1609855097
Registry record updated Jul 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A06103 Issued in IA
Practice address
326 3Rd Ave S
Clinton, IA 52732-4436
Phone
(563) 241-4295
Fax
(563) 242-9122
NPI assigned
Jan 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X A06103 IA Primary

Addresses

Primary practice location

326 3Rd Ave S
Clinton, IA 52732-4436

Mailing address

326 3Rd Ave S
Clinton, IA 52732-4436
Phone (563) 241-4295

Other identifiers 1

IdentifierTypeStateIssuer
1168823MedicaidIA

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel R Blohm DC PLC Chiropractor CurrentSince Dec 3, 2011 Accepting new patients

Locations

326 3rd Ave S
Clinton, IA 52732
Phone (563) 241-4295

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.

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279238400000",
    "number": "1609855097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 3RD AVE S",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527324436",
            "telephone_number": "563-241-4295",
            "fax_number": "563-242-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 3RD AVE S",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527324436",
            "telephone_number": "563-241-4295",
            "fax_number": "563-242-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAVENS",
        "first_name": "BART",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2010-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A06103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1168823",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.