Individual provider Active NPI

Leslie Lee Chisholm IV, DC

  • Chiropractor
  • Spring Hill, FL
National Provider Identifier
1811705122
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
15286 Issued in FL
Practice address
8466 Northcliffe Blvd
Spring Hill, FL 34606-1140
Phone
(352) 666-2222
NPI assigned
Dec 19, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 15286 FL Primary

Addresses

Primary practice location

8466 Northcliffe Blvd
Spring Hill, FL 34606-1140

Mailing address

17167 Hallandale Loop Apt 210
Land O Lakes, FL 34638-8254
Phone (813) 475-1387

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250110003168 FL Practitioner - Chiropractic 0749718203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hernando Healthcare Associates PAGroup PAC ID 6406844133, 12 clinicians

Practice addresses (Care Compare)

8466 Northcliffe Blvd
Spring Hill, FL 34606-1140
Phone 3526662222111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15286FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Hernando Healthcare Associates PA Chiropractor CurrentSince Dec 23, 2024 Accepting new patients

Locations

8466 Northcliffe Blvd
Spring Hill, FL 34606
Phone (352) 666-2222

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": "1734566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1811705122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17167 HALLANDALE LOOP APT 210",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346388254",
            "telephone_number": "813-475-1387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8466 NORTHCLIFFE BLVD",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346061140",
            "telephone_number": "352-666-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISHOLM",
        "first_name": "LESLIE",
        "middle_name": "LEE",
        "name_suffix": "IV",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-19",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "15286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Hill, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; 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.