Individual provider Active NPI

Bradley S. Leader, DC

  • Chiropractor
  • Auburn, NY
National Provider Identifier
1396766929
Registry record updated May 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X008312-1 Issued in NY
Practice address
2115 West Genesee Street
Auburn, NY 13021
Phone
(315) 252-5789
Fax
(315) 252-3113
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X008312-1 NY Primary

Addresses

Primary practice location

2115 West Genesee Street
Auburn, NY 13021

Mailing address

2115 West Genesee Street
Auburn, NY 13021
Phone (315) 252-5789

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
X008312-1NYMDChiropractor
008312NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Bryan E Leader Chiropractic LLC Chiropractor PastSince May 18, 2014 Accepting new patients
Leader Chiropractic Chiropractor Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304553600000",
    "number": "1396766929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 WEST GENESEE STREET",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "13021",
            "telephone_number": "315-252-5789",
            "fax_number": "315-252-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 WEST GENESEE STREET",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "13021",
            "telephone_number": "315-252-5789",
            "fax_number": "315-252-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEADER",
        "first_name": "BRADLEY",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2011-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X008312-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2011; 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.