Active NPI
Eric Michael Leitman, D.C.
- Sports Physician Chiropractor
- Saint Charles, MO
National Provider Identifier
1043655699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- 2013013332
- Practice address
- 1960 S Old Highway 94
Saint Charles, MO 63303-3727 - Phone
- (636) 925-1919
- Fax
- (636) 435-6144
- NPI assigned
- May 8, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | 2013013332 | MO | Primary |
Addresses
Primary practice location
1960 S Old Highway 94
Saint Charles, MO 63303-3727
Mailing address
74 Barton PL
Saint Charles, MO 63301-1778
Phone (636) 485-9972
Other practice location 1
3920 S Old Highway 94 Ste 33
Saint Charles, MO 63304-2835
Phone (636) 925-1919
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Logan College of Chiropractic, 2013
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3920 S Old Hwy 94
Suite 33
Saint Charles, MO 63304-2835
Phone (636) 925-1919
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2013013332 | MO | MD | Sports Physician Chiropractor |
Networks
- IA HMO
- IA HMO C-SNP
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Complete Performance Chiropractic
- Sports Physician Chiropractor
- Saint Peters, MO
- NPI 1063859601
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636502400000",
"number": "1043655699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "74 BARTON PL",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633011778",
"telephone_number": "636-485-9972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1960 S OLD HIGHWAY 94",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633033727",
"telephone_number": "636-925-1919",
"fax_number": "636-435-6144"
}
],
"practiceLocations": [
{
"address_1": "3920 S Old Highway 94 Ste 33",
"address_purpose": "LOCATION",
"city": "Saint Charles",
"state": "MO",
"postal_code": "633042835",
"country_code": "US",
"telephone_number": "636-925-1919",
"fax_number": "636-435-6144",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEITMAN",
"first_name": "ERIC",
"middle_name": "MICHAEL",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-08",
"last_updated": "2021-11-10",
"certification_date": "2021-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "MO",
"license": "2013013332",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Charles, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.