Provider Demographics
NPI:1508938234
Name:LEIGHTY, STEVEN D (PT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:D
Last Name:LEIGHTY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5799 BROADMOOR ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-2403
Mailing Address - Country:US
Mailing Address - Phone:913-384-5600
Mailing Address - Fax:913-384-0719
Practice Address - Street 1:8516 N OAK TRFY
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-2433
Practice Address - Country:US
Practice Address - Phone:816-436-4500
Practice Address - Fax:816-436-4510
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO100897225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
20085OtherPREFERRED HEALTH PROF
20085049OtherBLUE CROSS BLUE SHIELD KC
205424OtherPHCS
426923OtherHEALTHLINK
43181441064155A012OtherTRICARE
MOP00388636OtherMEDICARE RAILROAD
MOT66A967AOtherMEDICARE PART B