BRENT LEAVITT (NPI# 1851761464) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851761464 |
| Entity Type | Organization |
| Organization Name | BRENT LEAVITT |
| Other Organization Name | MAXIMUM SECURITY INC |
| Practice Address |
4928 Pleasant View Dr Chubbuck ID 83202-1640 |
| Practice Telephone | 2087609416 |
| Mailing Telephone | 2087609416 |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2015-09-25 |
| Authorized Official Name | BRENT R LEAVITT (OWNER) |
| Authorized Official Telephone | 2087609416 |
| Authorized Official Credential | PA-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
ID | Hospitals |
| Other Name | Type Code |
|---|---|
| maximum security inc | Other Name - Individual/Organization |
| Street Address |
4928 PLEASANT VIEW DR |
| City | CHUBBUCK |
| State | ID |
| Zip Code | 83202-1640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740650548 | Brent Leavitt | Physician Assistant | 4928 Pleasant View Dr, Chubbuck, ID 83202-1640 | 2015-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700379682 | Vera Whole Health, Wa PC | Clinic/Center | 219 Phil Meador Ave, Pocatello, ID 83202 | 2018-06-14 |
| 1649712597 | Angie M Mccurdy | Audiologist | 4155 Yellowstone Hwy, Pine Ridge Mall, Pocatello, ID 83202 | 2016-11-09 |
| 1285180836 | Beverly Grigg Jones | Counselor | 210 W. Burnside, Chubbuck, ID 83202 | 2016-09-01 |
| 1376992503 | Andrea Walsh | Nurse Practitioner | 1133 Call Creek Dr, Ste A, Pocatello, ID 83202 | 2016-06-08 |
| 1215381181 | Specialized Physical Therapy Pllc | Clinic/Center | 4141 Poleline Rd Ste A, Pocatello, ID 83202 | 2016-04-18 |
| 1457713588 | Jennifer Ann Gould | Radiologic Technologist | 907 Ryan Street, Chubbuck, ID 83202 | 2016-03-28 |
| 1154714897 | Phoenix Management LLC | Day Training, Developmentally Disabled Services | 10991 Deerridge Dr., Chubbuck, ID 83202 | 2015-03-05 |
| 1750781449 | Jennifer Lynn Seaich | Counselor | 4460 Center Way, Center Counseling, Pocatello, ID 83202 | 2014-08-29 |
| 1336562412 | Kurt Layton | Counselor | 337 Joel, Chubbuck, ID 83202 | 2014-01-27 |
| 1245653468 | Hannah's Place LLC | Occupational Therapist | 240 W Burnside Ave Ste D, Chubbuck, ID 83202 | 2014-01-23 |
| Find all providers in zip 83202 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053669598 | Teton Valley Health Care, Inc | General Acute Care Hospital | 120 E Howard Avenue, Driggs, ID 83422-5112 | 2012-08-15 |
| 1639406267 | Florence Hospital, LLC | General Acute Care Hospital | 1300 E State St, Suite 102, Eagle, ID 83616-7059 | 2009-11-03 |
| 1912132176 | Initiatives Healthcare, LLC | General Acute Care Hospital | 1205 N 11th St, Boise, ID 83702-4102 | 2009-05-18 |
| 1417122821 | Elmore Medical Center Specialty Physician Group | General Acute Care Hospital | 890 N 6th E, Mountain Home, ID 83647-2206 | 2008-04-25 |
| 1275703241 | North Canyon Medical Center, Inc. | General Acute Care Hospital | 267 North Canyon Drive, Gooding, ID 83330-1858 | 2008-03-06 |
| 1720298102 | Weiser Valley Hospital District | General Acute Care Hospital | 645 E. 5th Street, Weiser, ID 83672-2202 | 2007-05-23 |
| 1548320435 | Benewah Community Hospital | General Acute Care Hospital | 229 South 7th St, St Maries, ID 83861 | 2006-12-11 |
| 1295769537 | Gooding County Hospital District | General Acute Care Hospital | 1120 Montana St, Gooding, ID 83330-1858 | 2006-07-11 |
| 1881641629 | Weiser Valley Hospital District | General Acute Care Hospital | 645 E. 5th St., Weiser, ID 83672-2202 | 2006-05-27 |
| 1609826270 | Oneida County Hospital | General Acute Care Hospital | 150 N 200 W, Malad, ID 83252-1239 | 2006-05-12 |
| Find all providers with the same taxonomy | ||||
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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.