Individual provider Active NPI

Renee Christine Edwards Leichtfuss, D.C.

  • Chiropractor
  • Tampa, FL
National Provider Identifier
1396125530
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH11473 Issued in FL
Practice address
1602 W Sligh Ave
Suite 500
Tampa, FL 33604-5893
Phone
(813) 935-4744
NPI assigned
Jun 3, 2015
Last updated
Oct 26, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 012595 NY
Chiropractor 111N00000X CH11473 FL Primary

Addresses

Primary practice location

1602 W Sligh Ave
Suite 500
Tampa, FL 33604-5893

Mailing address

1602 W Sligh Ave
Suite 500
Tampa, FL 33604-5893
Phone (813) 935-4744

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
CH11473FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mar Primary Care LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19044/brand/3/csg/1/fhir/r4

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, 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": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1396125530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 W SLIGH AVE",
            "address_2": "SUITE 500",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336045893",
            "telephone_number": "813-935-4744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 W SLIGH AVE",
            "address_2": "SUITE 500",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336045893",
            "telephone_number": "813-935-4744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEICHTFUSS",
        "first_name": "RENEE",
        "middle_name": "CHRISTINE EDWARDS",
        "name_prefix": "Ms.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-03",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "012595",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH11473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; 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.