BENJAMIN GLEN LEAVITT (NPI# 1629157359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629157359 |
| Entity Type | Individual |
| Full Name | BENJAMIN GLEN LEAVITT |
| Credential | M.D. |
| Practice Address |
203 S Washington Ave Ste A Aurora MO 65605-1466 |
| Mailing Address |
600 W Cale St Monett MO 65708-2423 |
| Practice Telephone | 4176784022 |
| Practice Fax Number | 4176784025 |
| Mailing Telephone | 4172369295 |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 2004016417 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | MEDICAL LICENCE NUMBER | 2004016417 | 01 |
| MO | DEA NUMBER | BL8853815 | 01 |
| MO | AAFP I.D. NUMBER | 8070773 | 01 |
| Street Address |
203 S WASHINGTON AVE STE A |
| City | AURORA |
| State | MO |
| Zip Code | 65605-1466 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457413858 | Paul Berry Andelin | Family Medicine | 203 S Washington Ave Ste A, Aurora, MO 65605-1466 | 2006-12-14 |
| 1568524932 | John Robert Forsyth | Family Medicine | 203 S Washington Ave Ste A, Aurora, MO 65605-1466 | 2006-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265030845 | Rhonda Kay Newton | Massage Therapist | 22768 Mo-39 Suite B, Aurora, MO 65605 | 2020-10-15 |
| 1134609712 | Regional Services | Nurse Practitioner | 305 W Prospect St, Aurora, MO 65605 | 2018-08-14 |
| 1932545977 | Ozark Tri-county Health Care Consortium | Clinic/Center | 1810 South Carnation Dr., Aurora, MO 65605 | 2013-05-17 |
| 1376884353 | Mercy Hospital Springfield | Durable Medical Equipment & Medical Supplies | 729 Highland Street, Aurora, MO 65605 | 2013-03-15 |
| 1518241587 | Holly Lynn Wade | Counselor | 1119 S Elliot, Aurora, MO 65605 | 2011-10-07 |
| 1760785265 | Mercy Hospital Springfield | Durable Medical Equipment & Medical Supplies | 721 E Highland Street, Aurora, MO 65605 | 2010-12-06 |
| 1740488147 | Marilyn Ruth Wachner | Social Worker | 1604 1 2 S Elliott, Aurora, MO 65605 | 2007-07-06 |
| 1942372248 | Patricia Ann Clark | Counselor | 112 S. Madison, Aurora, MO 65605 | 2006-11-14 |
| 1003994732 | Darren Gene Cook | Counselor | Lifecare Family Services, 112 S. Madison, Aurora, MO 65605 | 2006-11-01 |
| 1295878981 | Mercy Hospital Aurora | General Acute Care Hospital | 500 Porter Ave, Aurora, MO 65605 | 2007-02-14 |
| Find all providers in zip 65605 | ||||
| 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. |
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| 1477167567 | 247 Doctor | Family Medicine | 22884 E Layton Ave, Aurora, CO 80015-6473 | 2020-09-04 |
| 1497384564 | Colleen Marie Markham | Family Medicine | 1550 S Potomac St Ste 200, Aurora, CO 80012-5432 | 2020-04-02 |
| 1477039931 | Augustine Rios | Family Medicine | 1532 Galena St Ste 300, Aurora, CO 80010-2236 | 2018-07-17 |
| 1114411410 | Unnati Upadhyay | Family Medicine | 2020 Ogden Ave Ste 3302020, Aurora, IL 60504-5894 | 2018-06-20 |
| 1346763448 | Blue Nile Clinic | Family Medicine | 11275 E Mississippi Ave Ste 2s3, Aurora, CO 80012-2825 | 2017-07-20 |
| 1346775343 | 5th Ave Family Practice & Cosmetics Pllc | Family Medicine | 2044 Clinton St, Unit B, Aurora, CO 80010-1003 | 2017-04-27 |
| 1669824694 | Vivirmed LLC | Family Medicine | 630 N Lake St, Aurora, IL 60506-3106 | 2016-07-01 |
| 1386094332 | Sarah Weinstein | Family Medicine | Academic Office One, #3611, 12631 E 17th Ave, Ms 496, Aurora, CO 80045 | 2016-06-20 |
| Find all providers in AURORA | ||||
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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.