Jeffery Shawn Leatherman, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

8740 Issued in FL

Practice address

431 E Hollywood Blvd
Mary Esther, FL 32569-2058

Phone

(850) 864-5300

Fax

(850) 864-3900

NPI assigned

Nov 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Suncoast Healthcare Professionals PLLCGroup PAC ID 0345364592, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Suncoast Healthcare Professionals PLLC

  • Sports Physician Chiropractor
  • Mary Esther, FL
  • NPI 1891862322
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389225600000",
    "number": "1679640155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 E HOLLYWOOD BLVD",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "325692058",
            "telephone_number": "850-864-5300",
            "fax_number": "850-864-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 E HOLLYWOOD BLVD",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "325692058",
            "telephone_number": "850-864-5300",
            "fax_number": "850-864-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEATHERMAN",
        "first_name": "JEFFERY",
        "middle_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2014-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "FL",
            "license": "8740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie Jean Knox, CRNA
• Notlie C Lammie
• Brittany Lane
• Larhonda Michelle Lang
• Cortney A Lara
• David Lee, FNP
• Legacy Home Care Services LLC
• Theodore Fulton Litschauer Jr.
• Living Beyond
• Lly Vision Services Inc.

• Sports Physician Chiropractor in Mary Esther, FL
• Providers in Mary Esther, FL by specialty
• Sports Physician Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2014; 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.