Individual provider Active NPI

Michelle Leach, D.C.

  • Chiropractor
  • San Diego, CA
National Provider Identifier
1679642771
Registry record updated Nov 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC27254 Issued in CA
Practice address
9474 Kearny Villa Rd Ste 111
San Diego, CA 92126-4596
Phone
(858) 231-1470
Fax
(858) 271-4754
NPI assigned
Nov 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC27254 CA Primary

Addresses

Primary practice location

9474 Kearny Villa Rd Ste 111
San Diego, CA 92126-4596

Mailing address

9474 Kearny Villa Rd Ste 111
San Diego, CA 92126-4596
Phone (858) 231-1470

Other identifiers 3

IdentifierTypeStateIssuer
DC0272540OtherCABLUE SHIELD OF CA
DC27254OtherCABLUE CROSS OF CA
DC27254OtherCASTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080514000897 CA Practitioner - Chiropractic 2163591231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9474 Kearny Villa Rd
Suite 113
San Diego, CA 92126-4596
Phone (858) 578-2070

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DC27254CAMDChiropractor
27254CAMDDental Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Michelle Leach Chiropractic Corp Chiropractor CurrentSince Apr 14, 2008 Accepting new patients

Locations

9474 Kearny Villa Rd
Ste 113
San Diego, CA 92126
Phone (858) 578-2070

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1679642771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9474 KEARNY VILLA RD STE 111",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264596",
            "telephone_number": "858-231-1470",
            "fax_number": "858-271-4754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9474 KEARNY VILLA RD STE 111",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264596",
            "telephone_number": "858-231-1470",
            "fax_number": "858-271-4754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEACH",
        "first_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC27254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "DC0272540",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF CA",
            "identifier": "DC27254",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "DC27254",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; 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.