Individual provider Active NPI

Robert Joseph Leeper, DC

  • Chiropractor
  • Paducah, KY
National Provider Identifier
1417009523
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4181 Issued in KY
Practice address
229 South Friendship Road
Paducah, KY 42003
Phone
(270) 554-9637
Fax
(270) 554-5337
NPI assigned
Jan 17, 2007
Last updated
Oct 2, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4181 KY Primary

Addresses

Primary practice location

229 South Friendship Road
Paducah, KY 42003

Mailing address

229 South Friendship Road
Paducah, KY 42003
Phone (270) 554-9637

Other identifiers 1

IdentifierTypeStateIssuer
000000062868OtherKYANTHEM BLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060111000028 KY Practitioner - Chiropractic 0749271401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 1981
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

229 S Friendship Rd
Paducah, KY 42003-5702

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4181KYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Leeper Chiropractic Center Chiropractor CurrentSince Mar 26, 1993 Accepting new patients
Walsh Chiropractic, PLLC Chiropractor Past Accepting new patients

Locations

229 S Friendship Rd
Paducah, KY 42003
Phone (270) 554-9637

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, 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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1417009523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 SOUTH FRIENDSHIP ROAD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "42003",
            "telephone_number": "270-554-9637",
            "fax_number": "270-554-5337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 SOUTH FRIENDSHIP ROAD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "42003",
            "telephone_number": "270-554-9637",
            "fax_number": "270-554-5337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEEPER",
        "first_name": "ROBERT",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "000000062868",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; 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.