Active NPI
Gary Leong, MD
- Family Medicine Physician
- De Pere, WI
National Provider Identifier
1801870514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 37143
- Practice address
- 1800 Lawrence Dr
De Pere, WI 54115-9108 - Phone
- (920) 983-3220
- NPI assigned
- Dec 6, 2005
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 37143 | WI | Primary |
Addresses
Primary practice location
1800 Lawrence Dr
De Pere, WI 54115-9108
Mailing address
1800 Lawrence Dr
De Pere, WI 54115-9108
Phone (920) 983-3220
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 37143 | Other | WV | LICENSE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37143 | WI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393891200000",
"number": "1801870514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 LAWRENCE DR",
"city": "DE PERE",
"state": "WI",
"postal_code": "541159108",
"telephone_number": "920-983-3220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 LAWRENCE DR",
"city": "DE PERE",
"state": "WI",
"postal_code": "541159108",
"telephone_number": "920-983-3220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEONG",
"first_name": "GARY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-06",
"last_updated": "2014-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "37143",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "37143",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in De Pere, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.