Organization Active NPI

Leeper Chiropractic Center

  • Chiropractor
  • Paducah, KY
National Provider Identifier
1184804056
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
LEEPER CHIROPRACTIC CENTER
Practice address
229 S Friendship Rd
Paducah, KY 42003-5702
Phone
(270) 554-9637
Fax
(270) 554-5337
NPI assigned
Nov 8, 2007
Last updated
Oct 2, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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

Authorized official

Name
Dr. Robert J Leeper, D.C.NPI 1417009523
Title
Doctor/Owner
Phone
(270) 554-9637

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

229 S Friendship Rd
Paducah, KY 42003-5702

Mailing address

229 S Friendship Rd
Paducah, KY 42003-5702
Phone (270) 554-9637

Other identifiers 1

IdentifierTypeStateIssuer
000000062868OtherKYANTHEM BLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040520001359 KY Part B Supplier - Clinic/Group Practice 4486645140 Receives reassigned benefits from 1 practitioner
Practice locations: Paducah, KY

National Provider Directory

National Provider Directory

Locations

229 S Friendship Rd
Paducah, KY 42003
Phone (270) 554-9637

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349136000000",
    "number": "1184804056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 S FRIENDSHIP RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420035702",
            "telephone_number": "270-554-9637",
            "fax_number": "270-554-5337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 S FRIENDSHIP RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420035702",
            "telephone_number": "270-554-9637",
            "fax_number": "270-554-5337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEEPER CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-08",
        "last_updated": "2012-10-02",
        "status": "A",
        "authorized_official_last_name": "LEEPER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "270-554-9637",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "000000062868",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.