Organization Active NPI

Enliven Chiropractic PLLC

  • Chiropractor
  • Bridgeport, WV
National Provider Identifier
1588911770
Registry record updated Apr 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
928 Issued in WV
Legal business name
ENLIVEN CHIROPRACTIC PLLC
Practice address
130 Professional PL
Bridgeport, WV 26330
Phone
(304) 933-9355
NPI assigned
Aug 7, 2012
Last updated
Apr 15, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2019

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

Authorized official

Name
Dr. James W Leonette, D.C.NPI 1235377896
Title
Owner
Phone
(304) 933-9355

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 928 WV Primary

Addresses

Primary practice location

130 Professional PL
Bridgeport, WV 26330

Mailing address

130 Professional PL
Bridgeport, WV 26330-4599
Phone (304) 933-9355

Other practice location 1

103 E Main St
Suite 3
Bridgeport, WV 26330-1706
Phone (304) 933-9355

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120927000162 WV Part B Supplier - Clinic/Group Practice 6709035223 Receives reassigned benefits from 3 practitioners
Practice locations: Bridgeport, WV

National Provider Directory

National Provider Directory

Locations

103 E Main St
Ste 3
Bridgeport, WV 26330
Phone (304) 933-9355

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1344297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555286400000",
    "number": "1588911770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 PROFESSIONAL PL",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263304599",
            "telephone_number": "304-933-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 PROFESSIONAL PL",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "26330",
            "telephone_number": "304-933-9355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 E Main St",
            "address_2": "Suite 3",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "WV",
            "postal_code": "263301706",
            "country_code": "US",
            "telephone_number": "304-933-9355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ENLIVEN CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-07",
        "last_updated": "2019-04-15",
        "status": "A",
        "authorized_official_last_name": "LEONETTE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-933-9355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WV",
            "license": "928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.