NPIMap

Organization Active NPI

Phillip K. Leblanc

  • Chiropractor
  • Beaumont, TX
National Provider Identifier
1215128889
Registry record updated Jun 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
9459 Issued in TX
Legal business name
PHILLIP K. LEBLANC
Practice address
1595 Cornerstone CT Ste a
Beaumont, TX 77706-3899
Phone
(409) 833-3080
Fax
(409) 833-9343
NPI assigned
Aug 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2008

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

Authorized official

Name
Dr. Phillip Keith Leblanc, D.C.NPI 1851390538
Title
Owner
Phone
(409) 833-3080

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 9459 TX Primary

Addresses

Primary practice location

1595 Cornerstone CT Ste a
Beaumont, TX 77706-3899

Mailing address

1595 Cornerstone CT Ste a
Beaumont, TX 77706-3899
Phone (409) 833-3080

Other identifiers 1

IdentifierTypeStateIssuer
164324901MedicaidTX

National Provider Directory

National Provider Directory

Locations

1595 Cornerstone Ct
Ste A
Beaumont, TX 77706
Phone (409) 833-3080

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1215128889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1595 CORNERSTONE CT STE A",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777063899",
            "telephone_number": "409-833-3080",
            "fax_number": "409-833-9343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 CORNERSTONE CT STE A",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777063899",
            "telephone_number": "409-833-3080",
            "fax_number": "409-833-9343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIP K. LEBLANC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "LEBLANC",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-833-3080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "9459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164324901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.