Individual provider Active NPI

John Leigh, DC

  • Sports Physician Chiropractor
  • Saint Michael, MN
National Provider Identifier
1447395686
Registry record updated May 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
3455 Issued in MN
Practice address
400 Central Ave E
Suite 70
Saint Michael, MN 55376-9525
Phone
(763) 497-2787
Fax
(763) 497-4325
NPI assigned
Feb 21, 2007
Last updated
May 8, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 3455 MN Primary

Addresses

Primary practice location

400 Central Ave E
Suite 70
Saint Michael, MN 55376-9525

Mailing address

13702 47TH St NE
Saint Michael, MN 55376-9499
Phone (763) 497-2787

Other identifiers 1

IdentifierTypeStateIssuer
226943100MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110104001211 MN Practitioner - Chiropractic 5496944662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Michael Spinal Rehab Center, IncGroup PAC ID 8628267879, 2 clinicians

Practice addresses (Care Compare)

400 Central Ave E
Suite 70
Saint Michael, MN 55376-4549
Phone (763) 497-2787

PO Box
306 400 Central Ave NE
St Michael, MN 55376-0306

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3455MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Michael Spinal Rehab Center Inc CurrentSince Oct 8, 2001 Accepting new patients
St. Michael Spinal Rehab Center, Inc CurrentSince Oct 8, 2001 Accepting new patients

Locations

400 Central Ave E
Saint Michael, MN 55376
Phone (763) 497-2020

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431043200000",
    "number": "1447395686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13702 47TH ST NE",
            "city": "SAINT MICHAEL",
            "state": "MN",
            "postal_code": "553769499",
            "telephone_number": "763-497-2787",
            "fax_number": "763-497-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CENTRAL AVE E",
            "address_2": "SUITE 70",
            "city": "SAINT MICHAEL",
            "state": "MN",
            "postal_code": "553769525",
            "telephone_number": "763-497-2787",
            "fax_number": "763-497-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIGH",
        "first_name": "JOHN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2015-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MN",
            "license": "3455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "226943100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Michael, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2015; 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.