Individual provider Active NPI

Danny Lynn Leatherwood, M.D.

  • Diagnostic Radiology Physician
  • Indianapolis, IN
National Provider Identifier
1821100066
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
01057770 Issued in IN
Practice address
714 N Senate Ave
Ste 100
Indianapolis, IN 46202-3763
Phone
(317) 715-6381
Fax
(317) 472-4566
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 35525 AZ
Diagnostic Radiology Physician 2085R0202X 01057770 IN Primary

Addresses

Primary practice location

714 N Senate Ave
Ste 100
Indianapolis, IN 46202-3763

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other identifiers 5

IdentifierTypeStateIssuer
620864298OtherTRICARE
1506086MedicaidTN
201010540MedicaidIN
4141784OtherTNBCBS PROVIDER NUMBER
P00860880OtherINRAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dleatherwood@direct.iuhealth.org

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20101012000328 IN Practitioner - Diagnostic Radiology 6901802842 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Tennessee, HSC, College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indiana University Radiology Associates IncGroup PAC ID 7315922267, 213 clinicians
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1111 Ronald Reagan Pkwy
Avon, IN 46123-7085
Phone (317) 963-0166

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

2401 W University Ave
Muncie, IN 47303-3428
Phone (765) 747-4274

416 E Maumee St
Angola, IN 46703-2015
Phone (260) 667-5548

5165 McCarty LN
Lafayette, IN 47905-8764
Phone (765) 448-8000

550 N University Blvd Room
Suite 0663
Indianapolis, IN 46202-5149

550 University Blvd
Indianapolis, IN 46202-5149
Phone (317) 948-7569

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35525AZMDDiagnostic Radiology Physician
01057770INMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Radiology Associates, Inc. Diagnostic Radiology CurrentSince Oct 1, 2010 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Oct 1, 2025 Accepting new patients
Southwest Diagnostic Imaging LLC Diagnostic Radiology PastSince Apr 20, 2021 Accepting new patients
Jackson Radiology Associates PA Diagnostic Radiology Past Accepting new patients

Locations

5924 Reliable Pkwy
Chicago, IL 60686

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

1701 Senate Blvd
#C6
Indianapolis, IN 46202
Phone (317) 962-9000

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

714 N Senate Ave
Ste 100
Indianapolis, IN 46202
Phone (317) 715-6402

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1000 S Main St
Tipton, IN 46072
Phone (765) 675-8500

Interoperability endpoints

  • Direct secure messaging: dleatherwo@yourcarecommunity.org
  • Direct secure messaging: dleatherwood@direct.iuhealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1821100066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 N SENATE AVE",
            "address_2": "STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462023763",
            "telephone_number": "317-715-6381",
            "fax_number": "317-472-4566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEATHERWOOD",
        "first_name": "DANNY",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "35525",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01057770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "620864298",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1506086",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201010540",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "4141784",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00860880",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dleatherwood@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "714 N Senate Ave",
            "address_2": "Ste 100",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462023763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.