Jessica Leavitt, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95010028 Issued in CA

Practice address

1300 N Dutton Ave
Santa Rosa, CA 95401-7112

Phone

(707) 396-5151

NPI assigned

Sep 26, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Utah Pediatric ServicesGroup PAC ID 0547552473, 129 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jleavitt236096@direct.med.utah.edu

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.

• University of Utah Pediatric Services

  • Pediatrics Physician
  • Salt Lake City, UT
  • NPI 1487018974
  Medicare reassignment Care Compare group NPD
• University of Utah Adult Services

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1114321981
  Medicare reassignment NPD
• University of Utah Adult Services

  • Physical Therapist
  • Salt Lake City, UT
  • NPI 1487000287
  NPD
• University of Utah Adult Services

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
  • NPI 1598169419
  NPD
• University of Utah Pediatric Services

  • Pediatric Hematology & Oncology Physician
  • Salt Lake City, UT
  • NPI 1104280684
  NPD
• University of Utah Pediatric Services

  • Pediatric Infectious Diseases Physician
  • Salt Lake City, UT
  • NPI 1285098855
  NPD
• Bronson Lakeview Hospital

  • Internal Medicine Physician
  • Paw Paw, MI
  • NPI 1235131137
  NPD (past)
• University of Utah Pediatric Services

  • Pediatrics Physician
  • Riverton, UT
  • NPI 1043671985
  NPD (past)

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1689159535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N DUTTON AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954017112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N DUTTON AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954017112",
            "telephone_number": "707-396-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAVITT",
        "first_name": "JESSICA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-26",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95010028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jleavitt236096@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy C Le, PHARM. D.
• Danny Chen Le, O.D.
• Nicole N Le, DDS
• Jillian Leach, RN
• Jodel Leano
• Robert Bernard Leavitt, PT, MPT, OCS, JSCC
• Zachary Lechler
• Abigail Lecomte, M.A., CCC-SLP
• Marissa Jeanne Lecount
• Bradly S Ledbetter

• Family Nurse Practitioner in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.