Individual provider Active NPI

Cecilia Ingrid Leppen, D.C.

  • Chiropractor
  • Southgate, MI
National Provider Identifier
1376606848
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
005986 Issued in MI
Practice address
15461 Dix Toledo Rd
Southgate, MI 48195-2662
Phone
(734) 246-7711
Fax
(734) 246-9287
NPI assigned
Dec 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 005986 MI Primary

Addresses

Primary practice location

15461 Dix Toledo Rd
Southgate, MI 48195-2662

Mailing address

15461 Dix Toledo Rd
Southgate, MI 48195-2662
Phone (734) 246-7711

Other identifiers 5

IdentifierTypeStateIssuer
027564OtherMIDMC
6097892OtherMICIGNA
OH25308OtherMIBLUE CROSS BLUE SHIELD
P102140OtherMIBCN
5511712OtherMIATENA

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
005986MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
New Boston Chiropractic Life Center, Corporation Chiropractor PastSince Dec 1, 2015 Accepting new patients
Beller Chiropractic Life Center, Inc Chiropractor Past Accepting new patients
Roberts Chiropractic Life Center, PLLC Chiropractor Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376606848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15461 DIX TOLEDO RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952662",
            "telephone_number": "734-246-7711",
            "fax_number": "734-246-9287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15461 DIX TOLEDO RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952662",
            "telephone_number": "734-246-7711",
            "fax_number": "734-246-9287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEPPEN",
        "first_name": "CECILIA",
        "middle_name": "INGRID",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "005986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMC",
            "identifier": "027564",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6097892",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "OH25308",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "P102140",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATENA",
            "identifier": "5511712",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.