Individual provider Active NPI

Robert John Leindecker, DC

  • Chiropractor
  • Grand Ledge, MI
National Provider Identifier
1922063809
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301006179 Issued in MI
Practice address
900 E Saginaw Hwy
Grand Ledge, MI 48837-9419
Phone
(517) 627-9111
Fax
(517) 627-1023
NPI assigned
Apr 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301006179 MI Primary

Addresses

Primary practice location

900 E Saginaw Hwy
Grand Ledge, MI 48837-9419

Mailing address

900 E Saginaw Hwy
Grand Ledge, MI 48837-9419
Phone (517) 627-9111

Other identifiers 3

IdentifierTypeStateIssuer
44-00210OtherMIPHYSICIANS HEALTH PLAN MI
4333928MedicaidMI
0B310220OtherMIBCBS OF MICHIGAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090421000684 MI Practitioner - Chiropractic 8729135140 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

900 E Saginaw Hwy
Crafted Care Chiropractic
Grand Ledge, MI 48837-9419
Phone (517) 627-9111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301006179MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Crafted Care Chiropractic Inc. Chiropractor CurrentSince Jul 30, 2001 Accepting new patients
Craft Chiropractic Center PC Chiropractor Current Accepting new patients
Jenison Chiropractic PLC Chiropractor Past Accepting new patients
Aaron N Kik, D.C., P.C. Chiropractor PastSince Feb 12, 2009 Accepting new patients

Locations

223 Lansing St
Charlotte, MI 48813
Phone (517) 543-1115

900 E Saginaw Hwy
Grand Ledge, MI 48837
Phone (517) 627-9111

11653 Hartel Rd
Ste 3750
Grand Ledge, MI 48837
Phone (517) 627-9111

Organizations & group practices 4

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1922063809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E SAGINAW HWY",
            "city": "GRAND LEDGE",
            "state": "MI",
            "postal_code": "488379419",
            "telephone_number": "517-627-9111",
            "fax_number": "517-627-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E SAGINAW HWY",
            "city": "GRAND LEDGE",
            "state": "MI",
            "postal_code": "488379419",
            "telephone_number": "517-627-9111",
            "fax_number": "517-627-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEINDECKER",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301006179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS HEALTH PLAN MI",
            "identifier": "44-00210",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4333928",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "0B310220",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Ledge, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.