Active NPI
Ronald Leavitt, MD
- Orthopaedic Hand Surgery Physician
- Fort Myers, FL
National Provider Identifier
1629059738
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Hand Surgery Physician
- License
- 042-0011868
- Practice address
- 12670 Creekside LN
Suite 202
Fort Myers, FL 33919-3370 - Phone
- (239) 482-2663
- NPI assigned
- Nov 7, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 21597 | CT | |
| Orthopaedic Hand Surgery Physician | 207XS0106X | 21597 | CT | |
| Orthopaedic Hand Surgery Physician | 207XS0106X | 042-0011868 | VT | Primary |
Addresses
Primary practice location
12670 Creekside LN
Suite 202
Fort Myers, FL 33919-3370
Mailing address
12670 Creekside LN
Suite 202
Fort Myers, FL 33919-3370
Phone (239) 482-2663
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001215979 | Medicaid | CT |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21597 | CT | MD | Orthopaedic Surgery Physician |
| 042-0011868 | VT | MD | Orthopaedic Hand Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361750400000",
"number": "1629059738",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12670 CREEKSIDE LN",
"address_2": "SUITE 202",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339193370",
"telephone_number": "239-482-2663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12670 CREEKSIDE LN",
"address_2": "SUITE 202",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339193370",
"telephone_number": "239-482-2663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEAVITT",
"first_name": "RONALD",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-07",
"last_updated": "2013-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "CT",
"license": "21597",
"primary": false
},
{
"code": "207XS0106X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Hand Surgery",
"state": "CT",
"license": "21597",
"primary": false
},
{
"code": "207XS0106X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Hand Surgery",
"state": "VT",
"license": "042-0011868",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001215979",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
- Gereiel Monae Leaphart
- Megan Ann Learn, OTR/L, M.S OT
- Vincent Wayne Leaver, LMHC
- Leavitt Medical Associates of Florida Inc (Advanced Dermatology and Cosmetic Surgery)
- Katarzyna Leavitt, MD
- Heidi Lynn Lecius, P.T.
- Nadia Ledea Vazquez
- Pamela Margaret Ledward, PAC
- Lee Cancer Clinic PLLC
- Lee Care Medical Transport
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.