Active NPI
Patrick Michael Leach Jr.
- Physical Therapy Assistant
- Columbia, MO
National Provider Identifier
1063785079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 225200000X
- Practice address
- 2011 Corona Rd
Columbia, MO 65203 - Phone
- (314) 523-3480
- NPI assigned
- Feb 22, 2012
- Last updated
- Feb 22, 2012
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 225200000X | MO | Primary |
Addresses
Primary practice location
2011 Corona Rd
Columbia, MO 65203
Mailing address
8228 Orville Ave
Kansas City, KS 66112
Phone (913) 522-3658
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 225200000X | MO | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329868800000",
"number": "1063785079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8228 ORVILLE AVE",
"city": "KANSAS CITY",
"state": "KS",
"postal_code": "66112",
"telephone_number": "913-522-3658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2011 CORONA RD",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "65203",
"telephone_number": "314-523-3480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEACH",
"first_name": "PATRICK",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-02-22",
"last_updated": "2012-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MO",
"license": "225200000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MO
- Quang Trong Trung Le, MD
- Lea's Home Health and Personal Care
- Lea's Home Health and Personal Care LLC
- Lea's Home Health and Personal Care LLC
- Lea's Home Health and Personal Care LLC
- James Paul Lear, PA-C
- Jacqueline Diane Leasure, FNP
- Madison Leigh Leatherman, LMSW
- Aron S. Lee, MD
- Brenna Elise Lee, FNP-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.