Randall R Leanna, D.C.
Individual provider Active NPI Chiropractor · Palmyra, WI
NPI 1831260876 · NPPES record last updated Nov 1, 2011
Key facts
- NPI
- 1831260876
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2787 - 012 (WI)
- Practice address
- 212 W. Main St
Palmyra, WI 53156-0250 - Phone
- (262) 495-4428
- Fax
- (262) 495-4480
- NPI assigned
- Nov 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
250 PO Box
Palmyra, WI 53156-0250
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120118000573 | WI | Practitioner - Chiropractic | 0547437493 | Practice locations: Palmyra, WI |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2787 - 012 | WI | MD | Chiropractor |
| 2787 | WI | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2787 - 012 | WI | Yes |
Addresses
Primary practice location
212 W. Main St
Palmyra, WI 53156-0250
Mailing address
PO Box 250
Palmyra, WI 53156-0250
Phone (262) 495-4428
Other providers in Palmyra, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.