Individual provider Active NPI

Kristi M Leindecker, M.D.

  • Family Medicine Physician
  • Dover, OH
National Provider Identifier
1457347619
Registry record updated Dec 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35074856L Issued in OH
Practice address
400 Medical Park Dr
Suite 201
Dover, OH 44622-3207
Phone
(330) 343-7709
NPI assigned
Sep 23, 2005
Last updated
Dec 8, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35074856L OH Primary

Addresses

Primary practice location

400 Medical Park Dr
Suite 201
Dover, OH 44622-3207

Mailing address

400 Medical Park Dr
Suite 201
Dover, OH 44622-3207
Phone (330) 343-7709

Other identifiers 1

IdentifierTypeStateIssuer
2089181MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091228000095 OH Practitioner - Family Practice 6709973340 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wright State University Boonshoft School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Union Physician Services LLCGroup PAC ID 0143366591, 97 clinicians

Practice addresses (Care Compare)

400 Medical Park Dr
Suite 201
Dover, OH 44622-3207
Phone (330) 364-2700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35074856LOHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union Physician Services, LLC Family Medicine CurrentSince Dec 26, 2014 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

110 Dublin Dr
Dover, OH 44622
Phone (330) 340-8038

110 Dublin Dr
#A
Dover, OH 44622
Phone (330) 364-8038

205 Hospital Dr
Dover, OH 44622
Phone (330) 343-3335

400 Medical Park Dr
Ste 201
Dover, OH 44622
Phone (330) 343-7709

Interoperability endpoints

  • Direct secure messaging: kleindecker1237495@direct.ccf.org
  • Direct secure messaging: kristileindecker@dpfm.allscriptsdirect.net

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417996800000",
    "number": "1457347619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MEDICAL PARK DR",
            "address_2": "SUITE 201",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446223207",
            "telephone_number": "330-343-7709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MEDICAL PARK DR",
            "address_2": "SUITE 201",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446223207",
            "telephone_number": "330-343-7709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEINDECKER",
        "first_name": "KRISTI",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-23",
        "last_updated": "2014-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35074856L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2089181",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, OH

Sources for this page

Verify at the official NPI Registry.