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DR. JEFFERY SHAWN LEATHERMAN D.C.
NPI 1679640155
Chiropractor - Sports Physician in Mary Esther, FL

Active since November 29, 2006Accepts Medicare Assignment
431 E HOLLYWOOD BLVD, MARY ESTHER, FL 32569(850) 864-5300(850) 864-3900 Get Directions Write a Review

NPPES record last updated: January 9, 2014. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Jeffery Shawn Leatherman D.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JEFFERY SHAWN LEATHERMAN D.C. (NPI 1679640155) is an individual sports physician in Mary Esther, Florida, licensed in Florida (8740) and active in the NPI registry since November 2006. He is a graduate of Other (2003).

NPPES Registry Identity

NPI1679640155
Entity TypeIndividualMale
Primary Taxonomy111NS0005X
Provider Legal NameDR. JEFFERY SHAWN LEATHERMANCredential: D.C.
Location Address431 E HOLLYWOOD BLVDMary Esther, FL 32569-2058
Mailing Address431 E Hollywood BlvdMary Esther, FL 32569-2058 · (850) 864-5300 · Fax (850) 864-3900
Phone(850) 864-5300
Fax(850) 864-3900
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateNovember 29, 2006
Last NPPES UpdateJanuary 9, 2014
✔ NPI 1679640155 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractor · Sports PhysicianChiropractic Providers
Taxonomy Code111NS0005X
License✔ Licensed in FL · 8740
Definition
A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities.
431 E HOLLYWOOD BLVD, Mary Esther, FL 32569
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jeffery Shawn Leatherman D.c. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3274711197
PECOS Enrollment IDI20110624000060

Medicare Billing Reassignment

Medicare enrollment records show Jeffery Leatherman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Suncoast Healthcare Professionals PLLC
Same address
Sports Physician
431 E HOLLYWOOD BLVD
Mary Esther, FL 32569
  • Reassigned Medicare billing, Florida enrollment
  • 6 clinicians in this Medicare group
NPI 1891862322 (850) 864-5300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SARAH LYNN SWISHER-LEATHERMAN D.C.
Chiropractor
431 E HOLLYWOOD BLVD
MARY ESTHER, FL 32569
Okaloosa County (850) 864-5300
DR. LEONARD WILLIAM FABIAN III D.C.
Chiropractor
431 E HOLLYWOOD BLVD
MARY ESTHER, FL 32569
Okaloosa County (850) 864-5300
TRENTEN D WESER D.C.
Chiropractor
431 E HOLLYWOOD BLVD
MARY ESTHER, FL 32569
Okaloosa County (937) 903-2735
SUNCOAST HEALTHCARE PROFESSIONALS PLLC
Chiropractor (Sports Physician)
431 E HOLLYWOOD BLVD
MARY ESTHER, FL 32569
Okaloosa County (850) 864-5300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeffery Leatherman's NPI number?

The NPI number for Jeffery Leatherman is 1679640155. It was assigned to this individual provider in the NPPES registry on November 29, 2006.

Where is Jeffery Leatherman located?

Jeffery Leatherman practices at 431 E Hollywood Blvd, Mary Esther, FL 32569. The listed phone number is (850) 864-5300.

What is Jeffery Leatherman's specialty?

The primary specialty registered for this NPI is Chiropractor, specializing in Sports Physician, with taxonomy code 111NS0005X.

Is Jeffery Leatherman enrolled in Medicare?

Yes. Jeffery Leatherman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jeffery Leatherman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jeffery Leatherman reassigns Medicare benefits to Suncoast Healthcare Professionals PLLC (Mary Esther, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jeffery Leatherman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jeffery Leatherman was last updated on January 9, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.