Individual provider Active NPI

Kevin Michael Leach, D.C.

  • Chiropractor
  • Anchorage, AK
National Provider Identifier
1962420232
Registry record updated Dec 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
366 Issued in AK
Practice address
4011 Arctic Blvd
Ste 203
Anchorage, AK 99503-5701
Phone
(907) 561-7041
Fax
(907) 561-2349
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 366 AK Primary

Addresses

Primary practice location

4011 Arctic Blvd
Ste 203
Anchorage, AK 99503-5701

Mailing address

4011 Arctic Blvd
Ste 203
Anchorage, AK 99503-5701
Phone (907) 561-7041

Other identifiers 1

IdentifierTypeStateIssuer
CH7932MedicaidAK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101220000592 AK Practitioner - Chiropractic 3870781792 Reassigns benefits to 1 organization
Practice locations: Anchorage, AK

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1000 O'Malley Rd
Suite 102
Anchorage, AK 99515-3083
Phone (907) 349-5552

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
366AKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Leach Health Services, LLC Chiropractor CurrentSince Aug 9, 2010 Accepting new patients

Locations

4011 Artic Blvd
Ste 203
Anchorage, AK 99503
Phone (907) 561-7041

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1962420232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 ARCTIC BLVD",
            "address_2": "STE 203",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995035701",
            "telephone_number": "907-561-7041",
            "fax_number": "907-561-2349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 ARCTIC BLVD",
            "address_2": "STE 203",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995035701",
            "telephone_number": "907-561-7041",
            "fax_number": "907-561-2349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEACH",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AK",
            "license": "366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH7932",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; 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.