1205878618 NPI number — DR. CHRISTOPHER LEONARDI DC

Table of content: MICHAEL C PATERAKOS M.D. (NPI 1861430183)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205878618 NPI number — DR. CHRISTOPHER LEONARDI DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEONARDI
Provider First Name:
CHRISTOPHER
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC
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:
1205878618
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/02/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10850 LOWELL AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OVERLAND PARK
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66210-1613
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-234-0700
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7070 W 107TH ST
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
OVERLAND
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66212-1810
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-381-4357
Provider Business Practice Location Address Fax Number:
913-381-4357
Provider Enumeration Date:
06/11/2006

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: 111N00000X , with the licence number:  4447 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1615371 . This is a "FIRST HEALTH & MAILHANDLE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 26690026K . This is a "BCBS OF KANSAS CITY" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 5561488 . This is a "AETNA PPO" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: P00060074 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 618199 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 480946127LEO . This is a "PREMIER HEALTH INS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 3347043 . This is a "AETNA HMO" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".




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