Keith C Leatherbury, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

18655 Issued in NE

Practice address

2830 N Clarkson St
Fremont, NE 68025-7718

Phone

(402) 721-6333

Fax

(402) 721-6320

NPI assigned

Jul 11, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Fremont Health Hospital, Fremont, NE, CCN 280077

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Physicians Clinic Inc

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1821049156

  Surgery

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Methodist Fremont Health

  • Rural Acute Care Hospital
  • Fremont, NE
  • NPI 1033698543
  Care Compare affiliation
• Methodist Fremont Health

  • Rural Acute Care Hospital
  • Fremont, NE
  • NPI 1376498543
  Care Compare affiliation

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1780682153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 N CLARKSON ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680257718",
            "telephone_number": "402-721-6333",
            "fax_number": "402-721-6320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 N CLARKSON ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680257718",
            "telephone_number": "402-721-6333",
            "fax_number": "402-721-6320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEATHERBURY",
        "first_name": "KEITH",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NE",
            "license": "18655",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NE",
            "license": "18655",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austinia Rebecca Latorra
• Diana Kay Laubscher, OTR/L
• Rita Lauer
• Raina Jane Le-Heuson
• Mark T Leahy, MD
• McKenzie Morgan Leedom
• Angela Marie Leeper, MSN ED, RN-BC
• Michelle Legrange
• Brenda Lembke, PLADC
• Melissa Lepore

• Surgery Physician in Fremont, NE
• Providers in Fremont, NE by specialty
• Surgery Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; 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.