1508938234 NPI number — STEVEN D LEIGHTY P.T.

Table of content: STEVEN D LEIGHTY P.T. (NPI 1508938234)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508938234 NPI number — STEVEN D LEIGHTY P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEIGHTY
Provider First Name:
STEVEN
Provider Middle Name:
D
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
P.T.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508938234
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/03/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5799 BROADMOOR ST
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
MISSION
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66202-2403
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-384-5600
Provider Business Mailing Address Fax Number:
913-384-0719

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8516 N OAK TRFY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64155-2433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-436-4500
Provider Business Practice Location Address Fax Number:
816-436-4510
Provider Enumeration Date:
11/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  100897 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 20085 . This is a "PREFERRED HEALTH PROF" identifier . This identifiers is of the category "OTHER".
  • Identifier: 20085049 . This is a "BLUE CROSS BLUE SHIELD KC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 205424 . This is a "PHCS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 426923 . This is a "HEALTHLINK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 43181441064155A012 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00388636 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: T66A967A . This is a "MEDICARE PART B" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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