NPIMap

Organization Active NPI

David C Leech DO Inc PC

  • Adult Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1770724916
Registry record updated Nov 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
A 830 86 Issued in NM
Legal business name
DAVID C LEECH DO INC PC
Practice address
101 Hospital Loop NE
Suite 114
Albuquerque, NM 87109-2129
Phone
(505) 888-7770
Fax
(505) 830-0846
NPI assigned
Mar 18, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2014

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

Authorized official

Name
David Charles Leech, DONPI 1831167410
Title
Owner
Phone
(505) 888-7770

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0505X A 830 86 NM Primary

Addresses

Primary practice location

101 Hospital Loop NE
Suite 114
Albuquerque, NM 87109-2129

Mailing address

101 Hospital Loop NE
Suite 114
Albuquerque, NM 87109-2129
Phone (505) 888-7770

Other identifiers 1

IdentifierTypeStateIssuer
00040915MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090708000106 NM Part B Supplier - Clinic/Group Practice 2860543618 Receives reassigned benefits from 1 practitioner
Practice locations: Albuquerque, NM

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
32D0881318David C Leech DO101 Hospital Loop NE Suite 114, Albuquerque, NM 87109Certificate of waiverAug 30, 2027

National Provider Directory

National Provider Directory

Locations

101 Hospital Loop NE
Ste 114
Albuquerque, NM 87109
Phone (505) 888-7770

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17606/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1237334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415836800000",
    "number": "1770724916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL LOOP NE",
            "address_2": "SUITE 114",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871092129",
            "telephone_number": "505-888-7770",
            "fax_number": "505-830-0846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL LOOP NE",
            "address_2": "SUITE 114",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871092129",
            "telephone_number": "505-888-7770",
            "fax_number": "505-830-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID C LEECH DO INC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-18",
        "last_updated": "2014-11-13",
        "status": "A",
        "authorized_official_last_name": "LEECH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-888-7770",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NM",
            "license": "A 830 86",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00040915",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.