LEON SHERBURN (NPI# 1376535740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376535740 |
| Entity Type | Individual |
| Full Name | LEON SHERBURN |
| Credential | D.O. |
| Practice Address |
525 S. Center St Hartford MI 49057-1362 |
| Mailing Address |
400 Medical Park Drive Watervliet MI 49098-9225 |
| Practice Telephone | 2696214063 |
| Practice Fax Number | 2696219972 |
| Mailing Telephone | 2696216416 |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2014-01-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 5101013070 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM | 08-5-14-0002-5 | 01 |
| MI | NPI | 1376535740 | 01 |
| MI | 114226839 | 05 | |
| MI | BCBSM - GROUP | 700A460030 | 01 |
| MI | 113392049 | 05 |
| Street Address |
525 S. CENTER ST |
| City | HARTFORD |
| State | MI |
| Zip Code | 49057-1362 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679833958 | Seth William Griffin | Dentist | 19 W. South St, Hartford, MI 49057 | 2012-05-21 |
| 1457624074 | Sandra Lynn Sharp | Social Worker | 57150 Cr. 681, Hartford, MI 49057 | 2012-02-13 |
| 1467647412 | Amanda Crystal-dawn Ramtahal | Social Worker | 57418 Cr. 681, Suite C., Hartford, MI 49057 | 2007-09-12 |
| 1447445697 | Traci Jo Drake | Social Worker | 57150 Cr 681, Hartford, MI 49057 | 2007-09-11 |
| 1639364888 | Tammy Sue Curtis | Social Worker | 57418 Cr 681, Suite C, Hartford, MI 49057 | 2007-09-11 |
| 1346340817 | Drs. Ed & Sue Liebenthal Plc | Dentist | 19 W.south St., Hartford, MI 49057 | 2006-09-25 |
| 1093177040 | Janette Rose Winters | Dental Hygienist | 57418 Cr 681, Hartford, MI 49057 | 2016-03-28 |
| 1295097889 | Van Buren Community Mental Health Authority | Social Worker | 57418 County Road 681, Suite C, Hartford, MI 49057 | 2012-06-11 |
| 1629371091 | Nora Adessa Fox-wentz | Psychologist | 57418 Cr. 681, Suite C, Hartford, MI 49057 | 2010-12-07 |
| 1982916045 | Van Buren Community Mental Health Authority | Counselor | 57418 Cr 681, Suite C, Hartford, MI 49057 | 2010-07-06 |
| Find all providers in zip 49057 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891159596 | Andrea Leigh Gillis | Family Medicine | Family Medicine Center At Asylum Hill, 99 Woodland St, Hartford, CT 06105 | 2016-04-08 |
| 1366679565 | William C Popik | Family Medicine | 90 Goodwin Cir, Hartford, CT 06105-5205 | 2009-06-15 |
| 1093989519 | Vivian Olsen Simmons | Family Medicine | 169 2nd Avenue, Hartford, AL 36344-1219 | 2008-04-15 |
| 1518130004 | Kamalpreet Dulai | Family Medicine | 110 Lone Oak Lane, Hartford, WI 53027 | 2008-04-07 |
| 1780877381 | Ohio County Hospital Corporation | Family Medicine | 20 Mcmurty Avenue, Hartford, KY 42347 | 2007-08-27 |
| 1912928169 | Collins Medical Associates 2 PC | Family Medicine | 95 Woodland St Fl 1, Hartford, CT 06105-1230 | 2006-07-22 |
| 1942225313 | Richard Thomas Kennedy | Family Medicine | 169 North Second Ave, Hartford, AL 36344 | 2006-07-13 |
| 1417908948 | Suzanne Gehl | Family Medicine | 1023 W State St, Hartford, WI 53027-2726 | 2006-05-12 |
| 1386609543 | Kellie Distefano | Family Medicine | 525 S Center St, Hartford, MI 49057-1362 | 2006-04-19 |
| 1851362180 | Kevin Lamont Collins | Family Medicine | 19 Woodland Street, Suite 42, Hartford, CT 06105 | 2006-01-26 |
| Find all providers in HARTFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.