Active NPI
Leavern Guy, R.K.T.
- Kinesiotherapist
- Picayune, MS
National Provider Identifier
1912009903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Kinesiotherapist
- License
- 1720
- Practice address
- 925 Clover Cir
Picayune, MS 39466-5436 - Phone
- (601) 273-1070
- NPI assigned
- Sep 1, 2006
- Last updated
- Jan 8, 2009
- 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 |
|---|---|---|---|---|
| Kinesiotherapist | 226300000X | 1720 | IL | Primary |
Addresses
Primary practice location
925 Clover Cir
Picayune, MS 39466-5436
Mailing address
925 Clover Cir
Picayune, MS 39466-5436
Phone (601) 273-1070
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1720 | IL | MD | Kinesiotherapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231372800000",
"number": "1912009903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "925 CLOVER CIR",
"city": "PICAYUNE",
"state": "MS",
"postal_code": "394665436",
"telephone_number": "601-273-1070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 CLOVER CIR",
"city": "PICAYUNE",
"state": "MS",
"postal_code": "394665436",
"telephone_number": "601-273-1070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUY",
"first_name": "LEAVERN",
"name_prefix": "Mr.",
"credential": "R.K.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-01",
"last_updated": "2009-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "226300000X",
"taxonomy_group": "",
"desc": "Kinesiotherapist",
"state": "IL",
"license": "1720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Picayune, MS
- John Michael Griffin, RPH
- Ward G. Griffing, D.D.S.
- Heather Dawn Grob, BSN, RN
- Growing Smiles of Picayune, PLLC
- Christian Avery Guelker, DPT
- Nicholas Paul Hahn, DO
- Georgia Hale
- Sarah Hamilton, PHARMD
- Hancock Medical Health Services, Inc. (Hancock Medical Health Services - HCSD)
- Rachel Hannaford, CPNP-PC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.