Individual provider Active NPI

Paul Micah Liechty, D.C.

  • Chiropractor
  • Cross Plains, WI
National Provider Identifier
1407003130
Registry record updated Jan 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
549212 Issued in WI
Practice address
1823 Bourbon Rd
Cross Plains, WI 53528-9436
Phone
(608) 798-3300
NPI assigned
Aug 25, 2008
Last updated
Jan 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 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 549212 WI Primary
Chiropractor 111N00000X 10956 TX

Addresses

Primary practice location

1823 Bourbon Rd
Cross Plains, WI 53528-9436

Mailing address

1823 Bourbon Rd
Cross Plains, WI 53528-9436
Phone (608) 798-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20081021000785 TX Practitioner - Chiropractic 3779641659 Reassigns benefits to 1 organization
I20200220002836 WI Practitioner - Chiropractic 3779641659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mjliechty Health ServicesGroup PAC ID 1759550338, 2 clinicians

Practice addresses (Care Compare)

1823 Bourbon Rd
Cross Plains, WI 53528-9436
Phone (608) 798-3300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
549212WIMDChiropractor
10956TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mjliechty Health Services Chiropractor CurrentSince Dec 17, 2010 Accepting new patients
American Integrated Healthcare PLLC Chiropractor CurrentSince Nov 8, 2018 Accepting new patients
Believe Corporation Chiropractor CurrentSince Jan 5, 2020 Accepting new patients

Locations

7562 S University Blvd
Centennial, CO 80122
Phone (303) 773-2020

3334 N Town East Blvd
Ste 102
Mesquite, TX 75150
Phone (972) 681-8321

1823 Bourbon Rd
Cross Plains, WI 53528
Phone (608) 798-3300

Organizations & group practices 3

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": "1219622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1407003130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1823 BOURBON RD",
            "city": "CROSS PLAINS",
            "state": "WI",
            "postal_code": "535289436",
            "telephone_number": "608-798-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1823 BOURBON RD",
            "city": "CROSS PLAINS",
            "state": "WI",
            "postal_code": "535289436",
            "telephone_number": "608-798-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIECHTY",
        "first_name": "PAUL",
        "middle_name": "MICAH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-25",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "549212",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "10956",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cross Plains, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.