Individual provider Active NPI

Eric Michael Leitman, D.C.

  • Sports Physician Chiropractor
  • Saint Charles, MO
National Provider Identifier
1043655699
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
2013013332 Issued in MO
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

Updated by the provider on Nov 10, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

Enrollment IDStateProvider typePAC IDDetails
I20130625000480 MO Practitioner - Chiropractic 9739328675 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
2013013332MOMDSports 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.

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.

Verify at the official NPI Registry.