Active NPI
Jennifer Leitner
- Prevention Professional
- Defiance, OH
National Provider Identifier
1962237743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prevention Professional
- License
- RA.164242
- Practice address
- 511 Perry St
Defiance, OH 43512-2123 - Phone
- (419) 782-9920
- NPI assigned
- Sep 3, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Prevention Professional | 405300000X | RA.164242 | OH | Primary |
Addresses
Primary practice location
511 Perry St
Defiance, OH 43512-2123
Mailing address
511 Perry St
Defiance, OH 43512-2123
Phone (419) 782-9920
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 |
|---|---|---|---|
| RA.164242 | OH | MD | Prevention Professional |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725321600000",
"number": "1962237743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "511 PERRY ST",
"city": "DEFIANCE",
"state": "OH",
"postal_code": "435122123",
"telephone_number": "419-782-9920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "511 PERRY ST",
"city": "DEFIANCE",
"state": "OH",
"postal_code": "435122123",
"telephone_number": "419-782-9920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEITNER",
"first_name": "JENNIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-03",
"last_updated": "2024-09-03",
"certification_date": "2024-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "OH",
"license": "RA.164242",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Defiance, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.