Keith J Leavell (NPI# 1184606311, PAC ID# 3678640406) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CRITICAL CARE (INTENSIVISTS).
| Nation Provider ID (NPI) | 1184606311 |
| PAC ID by PECOS | 3678640406 |
| Professional Enrollment ID | I20080922000028 |
| Full Name | Keith J Leavell |
| Organization Legal Name | CENTRACARE CLINIC |
| Address |
1586 County Rd Suite 134 Saint Cloud MN 56303-0346 |
| Phone Number | 3202510726 |
| Gender | M |
| Medical School | UNIVERSITY OF MICHIGAN MEDICAL SCHOOL |
| Graduation Year | 1988 |
| Primary Specialty | CRITICAL CARE (INTENSIVISTS) |
| Secondary Specialties | INTERNAL MEDICINE, PULMONARY DISEASE |
| Group Practice PAC ID | 2466363395 |
| Number of Group Practice Members | 601 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 240036 | ST CLOUD HOSPITAL |
| 241329 | LAKEWOOD HEALTH SYSTEM |
| 241362 | CENTRACARE HEALTH - MONTICELLO |
| Address | Phone | Organization |
|---|---|---|
| 1200 6th N Ave, Saint Cloud, MN 56303-2735 | 3202525131 | CENTRACARE CLINIC |
| 1586 County Rd, Suite 134, Saint Cloud, MN 56303-0346 | 3202510726 | CENTRACARE CLINIC |
| 1900 Centracare Cir, Saint Cloud, MN 56303-5000 | CENTRACARE CLINIC | |
| 1900 Centracare Circle, Saint Cloud, MN 56303-5000 | 3202522422 | CENTRACARE CLINIC |
| 1200 6th Ave N, St Cloud, MN 56303-2735 | 3202525131 | CENTRACARE CLINIC |
| 1406 6th Ave N, St Cloud, MN 56303-1901 | 8008356652 | CENTRACARE CLINIC |
| 1900 Centracare Circle, St Cloud, MN 56303-5000 | 3206543630 | CENTRACARE CLINIC |
| 49725 County, Suite 83, Staples, MN 56479-5280 | CENTRACARE CLINIC |
| Organization Legal Name | CENTRACARE CLINIC |
| Physicians | 630 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brittany D Kirkeby | Family Medicine | Centracare Clinic | 30 Railroad Ave, Albany, MN 56307-9379 |
| Stephanie A Boysen | Nurse Practitioner | Centracare Clinic | 615 Nelson Dr Po Box, Suite 217, Clearwater, MN 55320 |
| Evan L Dyce | Nurse Practitioner | Centracare Clinic | 1200 6th N Ave, Saint Cloud, MN 56303-2735 |
| Janelle M Terhaar | Nurse Practitioner | Centracare Clinic | 20 9th St Se, Long Prairie, MN 56347-1404 |
| Craig B Tangen | Certified Registered Nurse Anesthetist (crna) | Centracare Clinic | 3701 12th St N, Suite 202, Saint Cloud, MN 56303-2253 |
| Katrina N Wherry | Family Medicine | Centracare Clinic | 1360 Elm St E, St Joseph, MN 56374-4694 |
| Ashley A Rood | Nurse Practitioner | Centracare Clinic | 113 Waite Ave S, Suite 101, Waite Park, MN 56387-1348 |
| Elizabeth Anne Phillips | Urology | Centracare Clinic | 2351 Connecticut S Ave, 200 Suite 200, Sartell, MN 56377-2477 |
| Michelle L Jones | Nurse Practitioner | Centracare Clinic | 161 Glen St, Suite 101, Foley, MN 56329-4514 |
| Erin F Osmundson | Nurse Practitioner | Centracare Clinic | 500 Park St E, Annandale, MN 55302-3060 |
| Street Address |
1586 COUNTY RD SUITE 134 |
| City | SAINT CLOUD |
| State | MN |
| Zip | 56303-0346 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Troy A Payne | Sleep Medicine | Centracare Clinic | 1586 County Rd, Suite 134, Saint Cloud, MN 56303-0346 |
| Piyush Das | General Practice | Centracare Clinic | 1586 County Rd, Suite 134, Saint Cloud, MN 56303-0346 |
| Deborah A Scattarelli | Nurse Practitioner | Centracare Clinic | 1586 County Rd, Suite 134, Saint Cloud, MN 56303-0346 |
| Cathy S Klick | Nurse Practitioner | Centracare Clinic | 1586 County Rd, Suite 134, Saint Cloud, MN 56303-0346 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eugene J Beniek | Clinical Social Worker | 32104 Stearns County Rd, Suite 1, St Cloud, MN 56303 | |
| Troy A Scott | Family Medicine | St Cloud Hospital | 1572 County Rd, Suite 134, Saint Cloud, MN 56303-0346 |
| Paul M Wenner | Psychologist, Clinical | St Cloud Hospital | 1572 County Rd, Suite 134, Saint Cloud, MN 56303-0346 |
| Barbara A Carver | Psychologist, Clinical | St Cloud Hospital | 1572 County Rd, Suite 134, Saint Cloud, MN 56303-0346 |
| Judith L Huber | Psychologist, Clinical | Catholic Charities of The Diocese of St Cloud | 911 - 18th St N, Saint Cloud, MN 56303-1203 |
| Matthew R Eberly | Podiatry | St Cloud Foot and Ankle Center Pa | 106 Doctors Park, Saint Cloud, MN 56303-1207 |
| David J Patenaude | Podiatry | St Cloud Foot and Ankle Center Pa | 106 Doctors Park, Saint Cloud, MN 56303-1207 |
| Walter N Ellis | Podiatry | St Cloud Foot and Ankle Center Pa | 106 Doctors Park, Saint Cloud, MN 56303-1207 |
| Ashton J Nelsen | Podiatry | St Cloud Foot and Ankle Center Pa | 106 Doctors Park, Saint Cloud, MN 56303-1207 |
| James Rudolph Tuorila | Psychologist, Clinical | 103 Doctors Park, Saint Cloud, MN 56303-1207 | |
| Find all physicians in zip 56303 | |||
| City | SAINT CLOUD |
| Zip Code | 56303 |
| Specialty | CRITICAL CARE (INTENSIVISTS) |
| City + Specialty | SAINT CLOUD + CRITICAL CARE (INTENSIVISTS) |
Please comment or provide details below to improve the information on Keith J Leavell.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.