Individual provider Active NPI

Mable Marie Leckrone, D.C.

  • Internist Chiropractor
  • Liberty, MO
National Provider Identifier
1952325433
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internist ChiropractorTaxonomy code 111NI0900X
License
003838 Issued in MO
Practice address
257 W Mill St
Liberty, MO 64068-2339
Phone
(816) 781-8810
Fax
(816) 781-3468
NPI assigned
Jul 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internist Chiropractor 111NI0900X 003838 MO Primary

Addresses

Primary practice location

257 W Mill St
Liberty, MO 64068-2339

Mailing address

401 Smiley Rd
Liberty, MO 64068-7705
Phone (816) 781-8810

Other identifiers 1

IdentifierTypeStateIssuer
06055021OtherMOBLUE CROSS/ BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Chiropractic Center LLC PastSince Jul 1, 2005 Accepting new patients

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, 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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952325433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 SMILEY RD",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640687705",
            "telephone_number": "816-781-8810",
            "fax_number": "816-781-3468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 W MILL ST",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640682339",
            "telephone_number": "816-781-8810",
            "fax_number": "816-781-3468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LECKRONE",
        "first_name": "MABLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NI0900X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Internist",
            "state": "MO",
            "license": "003838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/ BLUE SHIELD",
            "identifier": "06055021",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.