Active NPI
Shenen Leavitt Dietrich, DO
- Hospitalist Physician
- Scottsdale, AZ
National Provider Identifier
1679549018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 3379
- Practice address
- 9377 E Bell Rd
Scottsdale, AZ 85260-1502 - Phone
- (480) 261-9409
- Fax
- (480) 619-4098
- NPI assigned
- Feb 26, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 3379 | AZ | |
| Hospitalist Physician | 208M00000X | 3379 | AZ | Primary |
Addresses
Primary practice location
9377 E Bell Rd
Scottsdale, AZ 85260-1502
Mailing address
9377 E Bell Rd
Scottsdale, AZ 85260-1502
Phone (480) 619-4097
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52849005 | Medicaid | AZ | |
| P00046563 | Other | AZ | RAIL ROAD MEDICARE ID |
| 582490 | Medicaid | AZ |
Other names 1
- Shenen Leavitt
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3379 | AZ | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Apogee Medical Group Inc | Internal Medicine | Past | Accepting new patients |
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.
-
- Internal Medicine Physician
- Phoenix, AZ
- NPI 1205883725
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463356800000",
"number": "1679549018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9377 E BELL RD",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852601502",
"telephone_number": "480-619-4097",
"fax_number": "480-619-4098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9377 E BELL RD",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852601502",
"telephone_number": "480-261-9409",
"fax_number": "480-619-4098"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIETRICH",
"first_name": "SHENEN",
"middle_name": "LEAVITT",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-26",
"last_updated": "2016-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AZ",
"license": "3379",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "AZ",
"license": "3379",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "52849005",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD MEDICARE ID",
"identifier": "P00046563",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "582490",
"state": "AZ"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SHENEN",
"last_name": "LEAVITT",
"credential": "DO",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.