Active NPI
Jerry Dale Leech Jr., DC
- Chiropractor
- Saint Peters, MO
National Provider Identifier
1730517574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2013036906
- Practice address
- 2730 S Saint Peters Pkwy
Suite 104
Saint Peters, MO 63303-5677 - Phone
- (636) 244-5239
- Fax
- (888) 241-0474
- NPI assigned
- Oct 14, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2013036906 | MO | Primary |
Addresses
Primary practice location
2730 S Saint Peters Pkwy
Suite 104
Saint Peters, MO 63303-5677
Mailing address
118 Brookside CT
Saint Louis, MO 63146-5604
Phone (314) 972-3107
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)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2013036906 | MO | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Institute for Regenerative Meidicine LLC | Current | Accepting new patients | |
| STL Injury and Spine LLC | Current | Accepting new patients | |
| American Pain Institute Inc | Past | Accepting new patients |
Organizations & group practices 3
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.
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- NPI 1134744725
-
- Family Medicine Physician
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- NPI 1740686658
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1381708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398470400000",
"number": "1730517574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 BROOKSIDE CT",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631465604",
"telephone_number": "314-972-3107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2730 S SAINT PETERS PKWY",
"address_2": "SUITE 104",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633035677",
"telephone_number": "636-244-5239",
"fax_number": "888-241-0474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEECH",
"first_name": "JERRY",
"middle_name": "DALE",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-10-14",
"last_updated": "2014-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MO",
"license": "2013036906",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Peters, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.