LEAH MARIE LIDDY (NPI# 1639698962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639698962 |
| Entity Type | Individual |
| Full Name | LEAH MARIE LIDDY |
| Credential | FNP-C |
| Practice Address |
3535 Southern Blvd Kettering OH 45429-1221 |
| Mailing Address |
2115 Leiter Rd Miamisburg OH 45342-3600 |
| Practice Telephone | 9373958166 |
| Mailing Telephone | 9373846800 |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2019-07-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | APRN.CNP.021683 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN.CNP.021683 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0249084 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 100 Kettering Way, Franklin, OH 450051155 | 9374584700 | |
| 4000 Miamisburg Centerville Rd, Miamisburg, OH 453427615 | 9373848791 | |
| 8701 Old Troy Pike, Huber Heights, OH 454241066 | 9375583338 | |
| 1141 N Monroe Dr, Xenia, OH 453851619 | 9373522500 | |
| 3535 Pentagon Blvd, Beavercreek, OH 454311705 | 9377024500 | |
| 2115 Leiter Rd, Miamisburg, OH 453423600 | 9373846800 | 9373846938 |
| 600 W Main St, Troy, OH 453732928 | 9379807010 | 9379807019 |
| 6147 State Route 122, Middletown, OH 450055201 | 5132613410 | 5132613419 |
| 405 W Grand Ave, Dayton, OH 454057538 | 9377233321 | 9377234609 |
| 1997 Miamisburg Centerville Rd, Centerville, OH 454593811 | 9374016228 | 9374016447 |
| 450 Washington Jackson Rd Ste F, Eaton, OH 453208699 | 9374568376 | 9374568377 |
| Street Address |
3535 SOUTHERN BLVD |
| City | KETTERING |
| State | OH |
| Zip Code | 45429-1221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134124183 | David M Brouhard | Anesthesiology | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2005-06-16 |
| 1245846757 | Rachel Henderson | Pharmacist | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-09-21 |
| 1235745043 | Nipa Mukesh Patel | Pharmacist | 3535 Southern Blvd, Kettering, OH 45429-1298 | 2020-09-17 |
| 1104437425 | Stephanie Elizabeth Nicholls | Hospitalist | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-08-11 |
| 1346865144 | Anesthesia Pearls, LLC | Nurse Anesthetist, Certified Registered | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-06-08 |
| 1568087351 | Pearl Lee | Nurse Anesthetist, Certified Registered | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-06-08 |
| 1922631761 | Michael Patrick Lorey | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-02-20 |
| 1801446315 | Madison A Tate | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2019-09-17 |
| 1962058966 | Joshua Caleb Courlas | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2019-08-15 |
| 1134775273 | Jason Raymond Leigh | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2019-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821576414 | Lauren Danielle Sivley | Nurse Practitioner | 3535 Sourthern Boulevard, Kettering, OH 45429 | 2018-08-06 |
| 1114446127 | Louai Al-samkari | Chiropractor | 1441 E. Stroop Rd., Kettering, OH 45429 | 2017-09-12 |
| 1407373756 | Benjamin Edward Adkins | Specialist/Technologist | 4116 Vinita Dr., Kettering, OH 45429 | 2017-08-28 |
| 1972036341 | James Kim | Student in an Organized Health Care Education/Training Program | 3535 Southern Boulevard, Kettering, OH 45429 | 2017-04-04 |
| 1023549847 | Adrienne Krysiak | Emergency Medicine | 3525 Southern Boulevard, Kettering, OH 45429 | 2017-03-23 |
| 1386021889 | Cassandra Mckoy | Counselor | 529 East Stroop Road, Kettering, OH 45429 | 2015-05-04 |
| 1417343088 | Candace Benoit | Obstetrics & Gynecology | 3533 Southern Blvd Ste 4600, Dayton, OH 45429 | 2015-04-10 |
| 1275933574 | Lee Schwieterman | Nurse Practitioner | 3535 Southern Blvd., 1 East, Kettering, OH 45429 | 2014-08-25 |
| 1497161947 | Robert Jonathon Fresch Jr. | Obstetrics & Gynecology | 3533 Southern Blvd Ste 3750, Kettering, OH 45429 | 2014-07-05 |
| 1821349812 | Lucas Brewer | Counselor | 1524 E Stroop Rd Ste 300, Kettering, OH 45429 | 2012-10-01 |
| Find all providers in zip 45429 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740500016 | Cheryl Dunlap Cnp LLC | Nurse Practitioner | 2267 Yorkshire Pl, Kettering, OH 45419-2833 | 2010-06-09 |
| 1912520719 | Rachel French Hunter | Nurse Practitioner | 2115 E Dorothy Ln, Kettering, OH 45420-1176 | 2020-05-27 |
| 1558900431 | Cristina Michelle Murphy | Nurse Practitioner | 2115 E Dorothy Ln, Kettering, OH 45420-1176 | 2019-12-25 |
| 1184265324 | Gretta Weindorf | Nurse Practitioner | 1362 E Stroop Rd, Kettering, OH 45429-4926 | 2019-09-30 |
| 1093375750 | Erika Vanwyck Thomas | Nurse Practitioner | 2115 E Dorothy Ln, Kettering, OH 45420-1176 | 2019-06-15 |
| 1952870594 | Jane Ashley Williamson | Nurse Practitioner | 3700 Southern Blvd, Kettering, OH 45429-1226 | 2018-11-13 |
| 1205325040 | Stephanie Westerbeck | Nurse Practitioner | 3535 Southern Blvd, Kettering, OH 45429 | 2018-05-08 |
| 1487142600 | Wanda Irene Blatter | Nurse Practitioner | 3313 Wilmington Pike, Kettering, OH 45429-4023 | 2018-04-23 |
| 1275032914 | Bradley David Boothe | Nurse Practitioner | 10 Southmoor Cir Nw, Kettering, OH 45429-2444 | 2018-02-08 |
| 1285147827 | Tiarah Alisha Todd | Nurse Practitioner | 10 Southmoor Cir Nw, Kettering, OH 45429-2444 | 2017-11-06 |
| Find all providers in KETTERING | ||||
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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.