Individual provider Active NPI

George J Leach, D.O.

  • Endocrinology, Diabetes & Metabolism Physician
  • Livonia, MI
National Provider Identifier
1871687061
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
5101006363 Issued in MI
Practice address
20270 Middlebelt Rd
Suite 10
Livonia, MI 48152-2000
Phone
(248) 476-1210
Fax
(248) 476-9280
NPI assigned
Oct 3, 2006
Last updated
Oct 17, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 5101006363 MI Primary
Nuclear Medicine Physician 207U00000X 5101006363 MI

Addresses

Primary practice location

20270 Middlebelt Rd
Suite 10
Livonia, MI 48152-2000

Mailing address

20270 Middlebelt Rd
Suite 10
Livonia, MI 48152-2000
Phone (248) 476-1210

Other identifiers 1

IdentifierTypeStateIssuer
4297465/11MedicaidMI

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
5101006363MIMDNuclear Medicine Physician

Organizations & group practices 1

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1871687061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20270 MIDDLEBELT RD",
            "address_2": "SUITE 10",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481522000",
            "telephone_number": "248-476-1210",
            "fax_number": "248-476-9280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20270 MIDDLEBELT RD",
            "address_2": "SUITE 10",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481522000",
            "telephone_number": "248-476-1210",
            "fax_number": "248-476-9280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEACH",
        "first_name": "GEORGE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MI",
            "license": "5101006363",
            "primary": true
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "MI",
            "license": "5101006363",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4297465/11",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.