Individual provider Active NPI

Alan Scott Leichter, D.C.

  • Chiropractor
  • South Bend, IN
National Provider Identifier
1972557361
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08001185 Issued in IN
Practice address
1622 Mishawaka Ave
South Bend, IN 46615-1427
Phone
(574) 288-1234
Fax
(574) 288-4821
NPI assigned
May 20, 2006
Last updated
Jul 28, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08001185 IN Primary

Addresses

Primary practice location

1622 Mishawaka Ave
South Bend, IN 46615-1427

Mailing address

1622 Mishawaka Ave
South Bend, IN 46615-1427
Phone (574) 288-1234

Other identifiers 1

IdentifierTypeStateIssuer
100366010MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101011000408 IN Practitioner - Chiropractic 8224220181 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1985
Medicare assignment
May accept Medicare assignment
Group practices
Chiropractic Health Center PCGroup PAC ID 6002042264, 2 clinicians

Practice addresses (Care Compare)

60930 US 31
South Bend, IN 46614-5148
Phone (574) 291-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Health Center, PC Chiropractor CurrentSince Jul 12, 2021 Accepting new patients
Impact Health Biometric Testing, Inc. Past Accepting new patients

Locations

60930 US 31 S
South Bend, IN 46614
Phone (574) 291-1000

Organizations & group practices 3

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217203200000",
    "number": "1972557361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1622 MISHAWAKA AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466151427",
            "telephone_number": "574-288-1234",
            "fax_number": "574-288-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 MISHAWAKA AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466151427",
            "telephone_number": "574-288-1234",
            "fax_number": "574-288-4821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEICHTER",
        "first_name": "ALAN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2008-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100366010",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; 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.