Brent Leavitt

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-1299 Issued in ID

Practice address

4928 Pleasant View Dr
Chubbuck, ID 83202-1640

Phone

(208) 760-9416

NPI assigned

Oct 6, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Medicare reassignment NPD
• Intermountain Emergency Physicians

  • Emergency Medicine Physician
  • Idaho Falls, ID
  • NPI 1124005467
  Medicare reassignment
• Leavitt Womens Healthcare Corp,P.C.

  • Obstetrics & Gynecology Physician
  • Idaho Falls, ID
  • NPI 1972771756
  Medicare reassignment
• Emergency Physicians Integrated Care, LLC

  • Emergency Medicine Physician
  • Salt Lake City, UT
  • NPI 1578598199

  ID

  Medicare reassignment
• Brent Leavitt

  • Critical Access Hospital
  • Chubbuck, ID
  • NPI 1851761464
  NPD (past) Authorized official

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444089600000",
    "number": "1740650548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4928 PLEASANT VIEW DR",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832021640",
            "telephone_number": "208-760-9416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4928 PLEASANT VIEW DR",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832021640",
            "telephone_number": "208-760-9416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAVITT",
        "first_name": "BRENT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-06",
        "last_updated": "2015-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Krichbaum, L.P.C.
• Zayne B Lanier
• Lisa K Larsen, LMSW
• Jennifer Petty Layton, LSW
• Kurt D. Layton, LCSW
• Haley N Ledbetter, DPT
• Joseph Daniel Lenihan, LCSW
• Jade Letourneau, LPC
• Amanda Lettig, MS SLP
• Ivy Lewis Lewis, LPN

• Physician Assistant in Chubbuck, ID
• Providers in Chubbuck, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.