Individual provider Active NPI

Breanna Leach, DC

  • Chiropractor
  • Saint Charles, MO
National Provider Identifier
1669170924
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2022049142 Issued in MO
Practice address
400 1St Capitol Dr Ste 409
Saint Charles, MO 63301-2886
Phone
(314) 390-1049
NPI assigned
Feb 16, 2023
Last updated
Feb 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2022049142 MO Primary

Addresses

Primary practice location

400 1St Capitol Dr Ste 409
Saint Charles, MO 63301-2886

Mailing address

601 SE Melody LN Ste 101
Lees Summit, MO 64063-4804
Phone (816) 219-1977

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2022049142MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Myocore, LLC Chiropractor CurrentSince Feb 1, 2023 Accepting new patients
Myocore, LLC Chiropractor CurrentSince Feb 19, 2023 Accepting new patients

Locations

2625 Butterfield Rd
Ste 301N
Oak Brook, IL 60523
Phone (800) 613-0922

7900 Lees Summit Rd
Kansas City, MO 64139
Phone (816) 373-4485

601 SE Melody Ln
Ste 101
Lees Summit, MO 64063

400 1st Capitol Dr
Ste 409
Saint Charles, MO 63301
Phone (314) 355-4700

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": "1676505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1669170924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 SE MELODY LN STE 101",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640634804",
            "telephone_number": "816-219-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 1ST CAPITOL DR STE 409",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012886",
            "telephone_number": "314-390-1049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEACH",
        "first_name": "BREANNA",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-16",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2022049142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.