NPIMap

Organization Active NPI

Thomas J. Leavitt MD PC

  • Hematology & Oncology Physician
  • Sagle, ID
National Provider Identifier
1841414166
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
M9379 Issued in ID
Legal business name
THOMAS J. LEAVITT MD PC
Practice address
284 Buck Run
Sagle, ID 83860
Phone
(208) 255-7564
Fax
(208) 255-7537
NPI assigned
Apr 11, 2007
Last updated
Dec 4, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Authorized official

Name
Thomas J Leavitt, MDNPI 1528075744
Title
Owner President
Phone
(208) 255-7564

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
Hematology & Oncology Physician 207RH0003X M9379 ID Primary

Addresses

Primary practice location

284 Buck Run
Sagle, ID 83860

Mailing address

284 Buck Run
Sagle, ID 83860
Phone (208) 255-7564

National Provider Directory

National Provider Directory

Locations

420 N Second Ave
Ste 103
Sandpoint, ID 83864
Phone (208) 263-6763

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1841414166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 BUCK RUN",
            "city": "SAGLE",
            "state": "ID",
            "postal_code": "83860",
            "telephone_number": "208-255-7564",
            "fax_number": "208-255-7537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "284 BUCK RUN",
            "city": "SAGLE",
            "state": "ID",
            "postal_code": "83860",
            "telephone_number": "208-255-7564",
            "fax_number": "208-255-7537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS J. LEAVITT MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "LEAVITT",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "208-255-7564",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "ID",
            "license": "M9379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sagle, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.

Verify at the official NPI Registry.