Individual provider Active NPI

Regina Yvonne Leverrier, MD

  • Psychiatry Physician
  • Fresno, CA
National Provider Identifier
1861557506
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G170039 Issued in CA
Practice address
4441 E Kings Canyon Road
Fresno, CA 93702
Phone
(559) 600-4099
NPI assigned
Dec 22, 2006
Last updated
Oct 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 180469 NY
Psychiatry Physician 2084P0800X 036.146208 IL
Psychiatry Physician 2084P0800X DR.48092 CO
Psychiatry Physician 2084P0800X G170039 CA Primary

Addresses

Primary practice location

4441 E Kings Canyon Road
Fresno, CA 93702

Mailing address

15257 W Warren Dr
Lakewood, CO 80228-6432
Phone (917) 328-0799

Other practice location 1

15257 W Warren Dr
Lakewood, CO 80228-6432
Phone (917) 328-0799

Other identifiers 1

IdentifierTypeStateIssuer
01885749MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090902000036 CO Practitioner - Psychiatry 0345232104 Reassigns benefits to 3 organizations
I20220729001230 CA Practitioner - PsychiatryPractitioner - Neurology 0345232104 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G170039CAMDPsychiatry Physician
DR.48092COMDPsychiatry Physician
036.146208ILMDPsychiatry Physician
180469NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gardner Family Health Network Inc CurrentSince Dec 13, 2022 Accepting new patients
TMS Solutions Inc Psychiatry CurrentSince Oct 13, 2018 Accepting new patients
Well Nourished LLC CurrentSince Jan 1, 2024 Accepting new patients
Gardner Family Health Network, Inc. CurrentSince Dec 13, 2022 Accepting new patients
Boulder Community Health CurrentSince Mar 2, 2015 Accepting new patients
Boulder Community Health CurrentSince Mar 2, 2015 Accepting new patients
Medical Healthcare Services P.C. Psychiatry PastSince Jan 1, 2012 Accepting new patients

Locations

160 E Virginia St
Ste 100
San Jose, CA 95112
Phone (408) 918-2618

1100 Balsam Ave
Boulder, CO 80304
Phone (303) 415-7000

4801 Riverbend Rd
Ste 300
Boulder, CO 80301
Phone (303) 415-8621

2801 Youngfield St
Ste 101
Golden, CO 80401
Phone (720) 512-1215

3150 N 12th St
Grand Junction, CO 81506
Phone (970) 242-5707

765 E Holland Ave
Ste 1
Spokane, WA 99218
Phone (509) 242-6005

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1861557506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15257 W WARREN DR",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802286432",
            "telephone_number": "917-328-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4441 E KINGS CANYON ROAD",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93702",
            "telephone_number": "559-600-4099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15257 W Warren Dr",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802286432",
            "country_code": "US",
            "telephone_number": "917-328-0799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVERRIER",
        "first_name": "REGINA",
        "middle_name": "YVONNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "180469",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036.146208",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR.48092",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G170039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01885749",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.