Active NPI
Allen W Leadbetter
- Surgery Physician
- Westerly, RI
National Provider Identifier
1790798023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- L5016
- Practice address
- 46 Wells St
Westerly, RI 02891-2924 - Phone
- (401) 596-0174
- Fax
- (401) 596-2266
- NPI assigned
- Aug 15, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | L5016 | RI | Primary |
Addresses
Primary practice location
46 Wells St
Westerly, RI 02891-2924
Mailing address
46 Wells St
Westerly, RI 02891-2924
Phone (401) 596-0174
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 225399 | Other | RI | BLUE SHIELD |
| 9002352 | Medicaid | RI | |
| 010005016RT101 | Other | CT | BLUE SHIELD |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L5016 | RI | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198627200000",
"number": "1790798023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "46 WELLS ST",
"city": "WESTERLY",
"state": "RI",
"postal_code": "028912924",
"telephone_number": "401-596-0174",
"fax_number": "401-596-2266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "46 WELLS ST",
"city": "WESTERLY",
"state": "RI",
"postal_code": "028912924",
"telephone_number": "401-596-0174",
"fax_number": "401-596-2266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEADBETTER",
"first_name": "ALLEN",
"middle_name": "W",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-15",
"last_updated": "2007-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "RI",
"license": "L5016",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "225399",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9002352",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "010005016RT101",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Westerly, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.