Kim M Leis-Keeling, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

X012138-1 Issued in NY

Practice address

2021 Western Ave
Albany, NY 12203-5069

Phone

(518) 869-3415

NPI assigned

Mar 31, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dr Kim Leis-Keeling DC PLLCGroup PAC ID 4789846841, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dr. Kim Leis-Keeling, DC, PLLC

  dba Spinal Wellness Center

  • Sports Physician Chiropractor
  • Albany, NY
  • NPI 1619233400
  Medicare reassignment Care Compare group NPD Authorized official
• Family Health & Sports Chiropractic

  • Chiropractor
  • Altamont, NY
  • NPI 1558438218
  NPD (past)
• Eagle Creek Chiropractic

  • Physical Therapist
  • Prior Lake, MN
  • NPI 1073847554
  NPD (past)
• Eagle Creek Wellness Center LLC

  • Chiropractor
  • Prior Lake, MN
  • NPI 1366631244
  NPD (past)

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1922069699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 WESTERN AVE",
            "address_2": "STE 102",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122035029",
            "telephone_number": "518-982-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 WESTERN AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122035069",
            "telephone_number": "518-869-3415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16 New Karner Rd",
            "address_purpose": "LOCATION",
            "city": "Guilderland",
            "state": "NY",
            "postal_code": "120849514",
            "country_code": "US",
            "telephone_number": "518-452-4941",
            "fax_number": "518-452-5475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEIS-KEELING",
        "first_name": "KIM",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4498",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NY",
            "license": "X012138-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "210K8LE",
            "state": "FM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC",
            "identifier": "45-4547459",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamie L Leichter, AU.D.
• Iesha Leigh
• Jacob Michael Leighton, PHARMD
• Jill F Lein, REGISTERED NURSE
• Matthew Conrad Leinung, M.D.
• Michele Leitze, DPT
• Judith Leland, OTR/L
• Paul E. Lemanski, M.D., F.A.C.P.
• Elizabeth Lemark Duncan, CCC-SLP
• Marissa Lembo

• Sports Physician Chiropractor in Albany, NY
• Providers in Albany, NY by specialty
• Sports Physician Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.