Jesse K Laverdiere, DO

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

02006562A Issued in IN

Practice address

11050 Mt Belvedere Blvd
Fort Drum, NY 13602-2603

Phone

(888) 838-1303

NPI assigned

Jun 11, 2020

Last updated

Aug 27, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1982229399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11050 MT BELVEDERE BLVD",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136022603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 MT BELVEDERE BLVD",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136022603",
            "telephone_number": "888-838-1303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVERDIERE",
        "first_name": "JESSE",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-11",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "02006562A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitchell Garrett Lamb, DMD
• Michael Lamont, PA-C
• Valerie Laroco, NP-C
• Kevin Lee Larose, PHYSICIAN ASSISTANT
• Taralee Lashway
• Roxanne Lawler, DENTAL HYGIENIST
• Alicia Lee, RDN
• Brandon Lukas Lee, MS, RD, CSSD, CCRP
• Brooke Rita Leonelli, PH.D.
• Mark D. Lessard, PH.D.

• General Practice Physician in Fort Drum, NY
• Providers in Fort Drum, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; 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.