Active NPI
Leland J From, MD
- Internal Medicine Physician
- Beloit, WI
National Provider Identifier
1861401796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 23638020
- Practice address
- 1969 W Hart Rd
Beloit, WI 53511-2230 - Phone
- (608) 363-5985
- Fax
- (608) 364-5452
- NPI assigned
- Aug 7, 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 23638020 | WI | Primary |
Addresses
Primary practice location
1969 W Hart Rd
Beloit, WI 53511-2230
Mailing address
1969 W Hart Rd
Beloit, WI 53511-2230
Phone (608) 363-5985
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10638 | Other | DEAN HEALTH PLAN HMO | |
| 30396900 | Medicaid | WI |
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 |
|---|---|---|---|
| 23638020 | WI | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1230940800000",
"number": "1861401796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1969 W HART RD",
"city": "BELOIT",
"state": "WI",
"postal_code": "535112230",
"telephone_number": "608-363-5985",
"fax_number": "608-364-5452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1969 W HART RD",
"city": "BELOIT",
"state": "WI",
"postal_code": "535112230",
"telephone_number": "608-363-5985",
"fax_number": "608-364-5452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FROM",
"first_name": "LELAND",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-07",
"last_updated": "2009-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "23638020",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEAN HEALTH PLAN HMO",
"identifier": "10638",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30396900",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beloit, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.