Active NPI
Robert Leach, DO
- Emergency Medicine Physician
- Henderson, NV
National Provider Identifier
1770575391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 44077-021
- Practice address
- 2408 Tour Edition Dr
Henderson, NV 89074-8300 - Phone
- (414) 334-0148
- NPI assigned
- Aug 19, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 44077-021 | WI | Primary |
Addresses
Primary practice location
2408 Tour Edition Dr
Henderson, NV 89074-8300
Mailing address
2408 Tour Edition Dr
Henderson, NV 89074-8300
Phone (414) 334-0148
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43510200 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44077-021 | WI | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DHHS,PHS,Naihs, Gallup Indian Medical Center | Current | Accepting new patients | |
| Nopah Vista Emergency Physicians LLC | Emergency Medicine | Past | Accepting new patients |
| Twin Valley Emergency Physicians LLC | Emergency Medicine | Past | Accepting new patients |
| Churchill Mangat Emergency Group PC | Emergency Medicine | Past | Accepting new patients |
| Emcare Physician Providers Inc | Emergency Medicine | Past | Accepting new patients |
Locations
516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326
Organizations & group practices 5
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.
-
- General Acute Care Hospital
- Gallup, NM
- NPI 1225002322
-
- Emergency Medicine Physician
- Fallon, NV
- NPI 1881905149
-
- Emergency Medicine Physician
- Mesquite, NV
- NPI 1558310797
-
- Emergency Medicine Physician
- Pahrump, NV
- NPI 1396794095
-
- Emergency Medicine Physician
- Mesquite, NV
- NPI 1467401604
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429488000000",
"number": "1770575391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2408 TOUR EDITION DR",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890748300",
"telephone_number": "414-334-0148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2408 TOUR EDITION DR",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890748300",
"telephone_number": "414-334-0148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEACH",
"first_name": "ROBERT",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-19",
"last_updated": "2015-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WI",
"license": "44077-021",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43510200",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.