Individual provider Active NPI

Eric Leeseberg, DPT

  • Physical Therapist
  • Asheville, NC
National Provider Identifier
1871022889
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P21840 Issued in NC
Practice address
20 Gala Dr Ste G-104
Asheville, NC 28803-8209
Phone
(828) 484-4200
Fax
(828) 585-6659
NPI assigned
Jun 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0014893 CO
Physical Therapist 225100000X 11187 SC
Physical Therapist 225100000X P21840 NC Primary

Addresses

Primary practice location

20 Gala Dr Ste G-104
Asheville, NC 28803-8209

Mailing address

408 Higuera St Ste 200
San Luis Obispo, CA 93401-6135
Phone (805) 788-0805

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221129000158 SC Practitioner - Physical Therapist in Private Practice 5698044691 Reassigns benefits to 2 organizations
I20230202003145 NC Practitioner - Physical Therapist in Private Practice 5698044691

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physical Therapy and Sports Medicine, Inc.Group PAC ID 6608205307, 6 clinicians

Practice addresses (Care Compare)

205 Fike Rec Ctr
Clemson, SC 29634-0001
Phone (561) 395-2920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P21840NCMDPhysical Therapist
11187SCMDPhysical Therapist
0014893COMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pro Physical Therapy, Inc. Physical Therapist CurrentSince Sep 14, 2022 Accepting new patients
University Physical Therapy and Sports Medicine, Inc. Physical Therapist CurrentSince Sep 9, 2024 Accepting new patients

Locations

3848 Fau Blvd
Ste 105
Boca Raton, FL 33431
Phone (561) 395-2920

60 Shuford Rd
Columbus, NC 28722
Phone (828) 894-0277

146 Thomas Green Blvd
Clemson, SC 29631
Phone (561) 395-2920

205 Fike Rec Ctr
Clemson, SC 29634
Phone (561) 395-2920

1109 E Rutherford St
#A
Landrum, SC 29356
Phone (864) 457-1077

535 Laurens Rd
Woodruff, SC 29388
Phone (864) 476-6600

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1871022889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 HIGUERA ST STE 200",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934016135",
            "telephone_number": "805-788-0805",
            "fax_number": "805-788-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 GALA DR STE G-104",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288038209",
            "telephone_number": "828-484-4200",
            "fax_number": "828-585-6659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEESEBERG",
        "first_name": "ERIC",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-05",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0014893",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "11187",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.