Active NPI
Evan Francis Leonardis
- Athletic Trainer
- Wilkes Barre, PA
National Provider Identifier
1710406780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 84 W South St
Wilkes Barre, PA 18701-1009 - Phone
- (570) 408-5000
- NPI assigned
- Sep 11, 2017
- Last updated
- Sep 11, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | NU | ||
| Athletic Trainer | 2255A2300X | PA | Primary |
Addresses
Primary practice location
84 W South St
Wilkes Barre, PA 18701-1009
Mailing address
301 N Main St
Wilkes Barre, PA 18711
Phone (908) 566-8232
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505088000000",
"number": "1710406780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 N MAIN ST",
"city": "WILKES BARRE",
"state": "PA",
"postal_code": "18711",
"telephone_number": "908-566-8232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "84 W SOUTH ST",
"city": "WILKES BARRE",
"state": "PA",
"postal_code": "187011009",
"telephone_number": "570-408-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEONARDIS",
"first_name": "EVAN",
"middle_name": "FRANCIS",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-11",
"last_updated": "2017-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "PA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilkes Barre, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.